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社区外展干预措施,将阿片类使用障碍患者与药物辅助治疗联系起来。

A community outreach intervention to link individuals with opioid use disorders to medication-assisted treatment.

机构信息

Lighthouse Institute, Chestnut Health Systems, 221 W. Walton, Chicago, IL 60610, United States of America.

Chestnut Health Systems, 448 Wylie Drive, Normal, IL 61761, United States of America.

出版信息

J Subst Abuse Treat. 2020 Jan;108:75-81. doi: 10.1016/j.jsat.2019.07.001. Epub 2019 Jul 10.

Abstract

Individuals with opioid use disorders (OUD) face significant barriers to accessing medication-assisted treatment (MAT), yet access to MAT is critical to reducing opioid-related fatality. This study evaluated a peer outreach and treatment linkage intervention in Chicago that is part of the Illinois Opioid State Targeted Response (STR) project to assist individuals with OUD in accessing MAT. The study uses the framework of the Opioid Use Disorder Cascade of Care to track progress through successive stages of the intervention and evaluated covariates of successful transitions across stages. Peer outreach workers contacted individuals in high-risk communities, conducted an eligibility screen, and scheduled eligible individuals to meet with project staff for treatment linkage. Over the 12-month study period (July 2017-June 2018), peer outreach workers conducted approximately 3308 encounters with individuals; 83% (n = 1638) were determined to be eligible for the intervention and agreed to an on-site linkage meeting. A majority of these (59%; n = 972) showed to the linkage meeting; most of these (92%, n = 890) were scheduled for a MAT intake appointment; and 86% (n = 765) of those scheduled showed to the MAT intake appointment. Most (91%; n = 696) of those who showed for treatment intake received a first dose, and 72% (n = 498) of these were in treatment at 30 days after their first dose. Several participant characteristics differentiated individuals that continued at each stage of the cascade model from those that did not. These findings demonstrate that the peer outreach and treatment linkage intervention may be successfully used to engage individuals with OUD into treatment.

摘要

患有阿片类药物使用障碍(OUD)的个体在获得药物辅助治疗(MAT)方面面临重大障碍,但获得 MAT 对于减少阿片类相关死亡至关重要。本研究评估了芝加哥的一项同伴外展和治疗联系干预措施,该措施是伊利诺伊州阿片类药物州目标反应(STR)项目的一部分,旨在帮助 OUD 个体获得 MAT。该研究使用阿片类药物使用障碍护理连续体框架来跟踪干预措施的各个阶段的进展,并评估了成功过渡到各个阶段的协变量。同伴外展工作者联系高风险社区的个人,进行资格筛选,并安排符合条件的个人与项目工作人员会面进行治疗联系。在为期 12 个月的研究期间(2017 年 7 月至 2018 年 6 月),同伴外展工作者与个人进行了大约 3308 次接触;83%(n=1638)被确定有资格参加干预,并同意进行现场联系会议。其中大多数(59%,n=972)出席了联系会议;这些人中的大多数(92%,n=890)被安排接受 MAT 摄入量预约;并且这些预约的 86%(n=765)出席了 MAT 摄入量预约。大多数(91%,n=696)接受治疗摄入的人接受了第一剂药物,其中 72%(n=498)在第一剂药物后 30 天接受了治疗。几个参与者特征区分了继续进行连续体模型各个阶段的个体与未继续进行的个体。这些发现表明,同伴外展和治疗联系干预措施可能成功用于使 OUD 个体参与治疗。

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