在初级保健中诱导用于阿片类药物使用障碍的药物治疗
Tristen L Hall1, Douglas H Fernald2, Vivian Jiang2
1From the Department of Family Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO (TLH, DHF, VJ, KC, JMW, DEN, LZ); and University of Kansas School of Medicine, Kansas City, KS (JWL). Tristen.Hall@cuanschutz.edu.
Journal of the American Board of Family Medicine : JABFM
|August 11, 2025
概括
初级保健团队越来越多地通过家庭,办公室和远程医疗诱导为阿片类药物使用障碍 (MOUD) 提供药物治疗. 患者的偏好和社会因素影响治疗,突出了实践适应阿片类药物流行病的情况.
科学领域:
- 成 药物 药物 药物 药物
- 初级保健研究研究初级保健研究
- 医疗保健服务研究 医疗服务研究
背景情况:
- 在过去的十年中,合成阿片类药物过量服用和死亡人数急剧增加.
- 在基于证据的阿片类药物使用障碍 (OUD) 治疗中存在重大差距,其中72%-87%的人没有接受阿片类药物使用障碍 (MOUD) 的药物治疗.
- 对初级保健实践团队在家中,办公室和远程医疗中使用MOUD诱导的经验的理解有限.
研究的目的:
- 探索初级保健实践团队使用家庭,办公室和远程医疗方法对MOUD诱导的经验.
- 确定在初级保健机构内提供MOUD的挑战和促进者.
主要方法:
- 与38名临床医生和来自21家美国初级保健实践的员工进行半结构化采访 (2023年2月至9月).
- 采访是PCORI资助的HOMER试验的一部分.
- 使用模板/编辑编码和沉浸结晶来识别主题的定性分析.
主要成果:
- 对MOUD的家庭诱导变得越来越普遍,患者和实践团队都更喜欢.
- 健康的社会决定因素显著影响MOUD的诱导和维护.
- 诚实的沟通促进了信任的患者关系; 实践适应不断变化的OUD环境.
结论:
- 初级保健实践表明,他们对提供MOUD有强烈的承诺.
- 研究结果为初级保健所需的挑战和适应提供了关键的见解,以有效地应对阿片类药物流行病.
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