The University of Texas at Austin College of Pharmacy, 2409 University Ave, Austin, TX 78712, USA; University Health System, 1055 Ada St., San Antonio, TX 78223, USA.
The University of Texas at Austin College of Pharmacy, 2409 University Ave, Austin, TX 78712, USA.
J Subst Abuse Treat. 2020 Dec;119:108141. doi: 10.1016/j.jsat.2020.108141. Epub 2020 Sep 22.
Research has recommended a combination of pharmacotherapy and behavioral therapy to treat opioid use disorder (OUD) or alcohol use disorder (AUD). The objective of this study was to estimate the prevalence of U.S. outpatient visits in which patients had a documented OUD or AUD and in what proportion of these visits the patient was receiving medication for OUD (MOUD) or AUD (MAUD), alone or in combination with behavioral therapy.
Cross-sectional analysis of the National Ambulatory Medical Care Survey (NAMCS) from 2014 to 2016.
NAMCS provides national estimates based on the latest census data, for all U.S. outpatient medical visits.
PARTICIPANTS/CASES: All visits involving patients aged ≥18 years with an OUD or AUD diagnosis.
Medications for OUD included buprenorphine, buprenorphine/naloxone, or naltrexone; medications for AUD included acamprosate, disulfiram, or naltrexone. We defined behavioral therapy as provision of psychosocial therapy, mental health counseling, or stress management. We also compared annualized data between 2014 and 2016 using the Chi-square test.
From 2014 to 2016, NAMCS recorded nearly 2.3 billion adult outpatient visits, including 17.1 million and 21.7 million visits involving patients with an OUD or AUD diagnosis, respectively. From 2014 to 2016, a decreased prevalence of annual visits involved AUD (11.7 vs. 9.9/1000, P < 0.0001), while those for OUD increased (9.3 vs. 13.3/1000, P < 0.0001). Among office visits with an OUD diagnosis, a MOUD was documented in 14.2 million (83.1%) visits and behavioral therapy was provided in 4.4 million (25.6%). Among office visits with an AUD diagnosis, an MAUD was documented in approximately 800,000 (3.6%) and behavioral therapy in 5.4 million (24.8%).
These data highlight an opportunity to increase the use of MAUD and offer behavioral therapy to those with OUD and/or AUD.
研究建议将药物治疗和行为治疗相结合，以治疗阿片类药物使用障碍（OUD）或酒精使用障碍（AUD）。本研究的目的是评估美国门诊就诊中记录有 OUD 或 AUD 的患者的比例，以及在这些就诊中，有多少患者单独或联合行为治疗接受 OUD（MOUD）或 AUD（MAUD）治疗。
对 2014 年至 2016 年全国门诊医疗调查（NAMCS）进行横断面分析。
NAMCS 根据最新的人口普查数据提供全国性估计值，涵盖所有美国门诊医疗就诊。
参与者/病例：所有涉及年龄≥18 岁的 OUD 或 AUD 诊断患者的就诊。
OUD 药物治疗包括丁丙诺啡、丁丙诺啡/纳洛酮或纳曲酮；AUD 药物治疗包括阿坎酸、双硫仑或纳曲酮。我们将行为治疗定义为提供心理社会治疗、心理健康咨询或压力管理。我们还使用卡方检验比较了 2014 年和 2016 年的年度数据。
2014 年至 2016 年，NAMCS 记录了近 23 亿例成年门诊就诊，其中分别有 1710 万和 2170 万就诊涉及 OUD 或 AUD 诊断的患者。2014 年至 2016 年，AUD 年度就诊的患病率下降（11.7 比 9.9/1000，P<0.0001），而 OUD 就诊的患病率增加（9.3 比 13.3/1000，P<0.0001）。在 OUD 诊断的门诊就诊中，1420 万（83.1%）就诊记录了 MOUD，440 万（25.6%）就诊提供了行为治疗。在 AUD 诊断的门诊就诊中，约有 80 万（3.6%）就诊记录了 MAUD，540 万（24.8%）就诊提供了行为治疗。
这些数据突显了增加 MAUD 使用和为 OUD 和/或 AUD 患者提供行为治疗的机会。
