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阿片类药物使用障碍和注射相关感染的综合门诊治疗:一种新的护理模式的描述。

Integrated outpatient treatment of opioid use disorder and injection-related infections: A description of a new care model.

机构信息

Division of Infectious Disease, Center on Drug and Alcohol Research, University of Kentucky, 845 Angliana Ave., Lexington, KY 40508, United States of America.

Center on Drug and Alcohol Research, University of Kentucky, United States of America.

出版信息

Prev Med. 2019 Nov;128:105760. doi: 10.1016/j.ypmed.2019.105760. Epub 2019 Jun 26.

Abstract

Persons with opioid use disorder (OUD) hospitalized with severe, injection-related infections (SIRI) are frequently hospitalized for the duration of IV antibiotic treatment due to concerns regarding their eligibility for outpatient parenteral antimicrobial therapy (OPAT), which is the standard of care for prolonged IV antibiotic courses for patients without drug use. As part of a pilot study, a novel, integrated care model was developed where patients with OUD and SIRI receive addiction consultation and buprenorphine induction while hospitalized, followed by ongoing management in an outpatient clinic that combines office-based opioid treatment with buprenorphine pharmacotherapy and counseling services with OPAT. Through three illustrative case vignettes the outpatient model is described along with challenges, lessons learned and future directions.

摘要

患有阿片类药物使用障碍(OUD)并因严重、与注射相关的感染(SIRI)住院的患者,由于担心其是否有资格接受门诊静脉内抗菌治疗(OPAT),通常会在住院期间接受静脉内抗生素治疗,OPAT 是对无药物使用的患者进行长期静脉内抗生素治疗的标准。作为一项试点研究的一部分,开发了一种新的综合护理模式,其中患有 OUD 和 SIRI 的患者在住院期间接受成瘾咨询和丁丙诺啡诱导治疗,然后在门诊诊所进行持续管理,该诊所将基于办公室的阿片类药物治疗与丁丙诺啡药物治疗和咨询服务相结合,并结合 OPAT。通过三个说明性案例,描述了门诊模式以及面临的挑战、经验教训和未来方向。

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