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阿片类药物使用障碍患者药物辅助治疗方案相关的戒断和保留趋势。

Trends in Abstinence and Retention Associated with a Medication-Assisted Treatment Program for People with Opioid Use Disorders.

出版信息

Prog Community Health Partnersh. 2020;14(1):43-54. doi: 10.1353/cpr.2020.0007.

Abstract

BACKGROUND

Medication-assisted treatment (MAT) is an evidence-based program for patients with opioid use disorders. Yet, within the state of Utah, MAT had not been widely available, promoted, or adopted within the public sector. Recognizing the potential benefit, a collective impact approach was used to promote social change and increase the use of MAT in the community for treatment of opioid use disorders.

OBJECTIVE

Conduct a retrospective, observational case series study to measure the effect of a community-based, collective impact approach implementing the MAT program to improve the rate of abstinence and retention among individuals identified with an opioid use disorder in three Utah counties.

METHODS

The study was designed and implemented by the Utah Opioid Community Collaborative (OCC) using a collective impact approach, which included broad sector coordination (public-private collaboration), a common agenda, participation in mutually reinforcing activities, continuous communication, consistent measurement of results, and identification of a backbone organization. The MAT intervention program includes use of medications approved by the U.S. Food and Drug Administration in combination with counseling and behavioral therapies delivered within two community sites. Analysis was performed over time to describe the rate of abstinence and retention associated with participation in the MAT program during 2015 through 2017.

RESULTS

Of the 339 identified with risk of an opioid use disorders, 228 enrolled in the MAT Program. At MAT enrollment, average age was 32.6 ± 8.2 years old and 58.0% were female. At 365 days after MAT enrollment, 84% of participants were abstinent from opioid substances and 62% from all illicit substances.

CONCLUSIONS

Use of a collective impact approach provides a successful mobilization framework in Utah for increasing community engagement and expanding patient access to underresourced MAT programs while suggesting a high rate of abstinence from illicit substances at 12 months.

摘要

背景

药物辅助治疗(MAT)是一种针对阿片类药物使用障碍患者的循证方案。然而,在犹他州,MAT 并没有在公共部门广泛推广或采用。认识到潜在的好处,采用集体影响方法来促进社会变革,增加社区内 MAT 的使用,以治疗阿片类药物使用障碍。

目的

进行回顾性、观察性病例系列研究,以衡量在犹他州三个县实施 MAT 方案的基于社区的集体影响方法对提高阿片类药物使用障碍患者的戒断率和保留率的效果。

方法

该研究由犹他州阿片类药物社区协作组织(OCC)设计和实施,采用集体影响方法,包括广泛的部门协调(公私合作)、共同议程、参与相互增强的活动、持续的沟通、对结果的一致衡量以及确定骨干组织。MAT 干预方案包括使用美国食品和药物管理局批准的药物,并结合在两个社区场所提供的咨询和行为疗法。分析随时间进行,以描述在 2015 年至 2017 年期间参加 MAT 方案与戒断和保留率的关联。

结果

在 339 名被确定有阿片类药物使用障碍风险的人中,有 228 人参加了 MAT 方案。在 MAT 入组时,平均年龄为 32.6 ± 8.2 岁,58.0%为女性。在 MAT 入组后 365 天,84%的参与者戒断阿片类物质,62%的人戒断所有非法物质。

结论

在犹他州,采用集体影响方法为增加社区参与度和扩大患者获得资源不足的 MAT 方案提供了一个成功的动员框架,同时表明在 12 个月时,非法物质的戒断率很高。

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The Opioid Epidemic: Crisis and Solutions.阿片类药物泛滥:危机与解决方案。
Annu Rev Pharmacol Toxicol. 2018 Jan 6;58:143-159. doi: 10.1146/annurev-pharmtox-010617-052534. Epub 2017 Oct 2.

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