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在联邦合格健康中心丁丙诺啡项目中留住具有多种脆弱性的患者:宾夕法尼亚州,2017-2018 年。

Retention of Patients With Multiple Vulnerabilities in a Federally Qualified Health Center Buprenorphine Program: Pennsylvania, 2017-2018.

机构信息

Lara Carson Weinstein, Qais Iqbal, Amy Cunningham, and Alexis Silverio are with the Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA. Robin Debates, Greg Landistratis, and Patrick Doggett are with Project HOME Health Services, Philadelphia.

出版信息

Am J Public Health. 2020 Apr;110(4):580-586. doi: 10.2105/AJPH.2019.305525. Epub 2020 Feb 20.

Abstract

To describe and report initial outcomes of a low-threshold, group-based primary care medication for opioid use disorder (OUD) program in a federally qualified health center. We performed a retrospective chart review of patients enrolled in the program from October 4, 2017, to October 3, 2018, in Philadelphia, Pennsylvania. The main outcome measure was time retained in treatment, defined as time from treatment initiation to unplanned treatment termination. Secondary outcomes were the relationships between treatment retention and cocaine use or housing status. We analyzed retention in treatment using Kaplan-Meier survival estimates. The 3- and 6-month retention rates were 82% and 63%, respectively. The log-rank test showed no significant differences for comparisons between homeless versus not homeless ( = .25) and cocaine use versus no cocaine use ( = .12).s. The medication for OUD program engaged a large number of patients from marginalized groups. Three- and 6-month retention rates were comparable with those reported of other federally qualified health center populations. Integrating treatment of OUD into primary care shows promise for increasing access to and retention in medication for OUD services. The federally qualified health center payment structure supports the sustainability of the group visit model.

摘要

描述并报告在一家联邦合格健康中心开展的基于小组的、针对阿片类药物使用障碍(OUD)的初级保健药物治疗方案的初步结果。我们对 2017 年 10 月 4 日至 2018 年 10 月 3 日期间在宾夕法尼亚州费城参与该方案的患者进行了回顾性图表审查。主要结局指标是治疗保留时间,定义为从治疗开始到非计划治疗终止的时间。次要结局是治疗保留与可卡因使用或住房状况之间的关系。我们使用 Kaplan-Meier 生存估计分析了治疗保留情况。3 个月和 6 个月的保留率分别为 82%和 63%。对数秩检验显示,无家可归者与非无家可归者之间( = .25)和可卡因使用者与非可卡因使用者之间( = .12)的比较无显著差异。OUD 药物治疗方案吸引了大量来自边缘化群体的患者。3 个月和 6 个月的保留率与其他联邦合格健康中心人群报告的保留率相当。将 OUD 治疗纳入初级保健有望增加获得和保留 OUD 药物治疗服务的机会。联邦合格健康中心的支付结构支持小组就诊模式的可持续性。

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