Department of Internal Medicine, Dell Medical School at The University of Texas at Austin, Austin, Texas.
Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California.
J Hosp Med. 2021 Jun;16(6):345-348. doi: 10.12788/jhm.3591.
Despite evidence that medications for patients with opioid use disorder (OUD) reduce mortality and improve engagement in outpatient addiction treatment, these life-saving medications are underutilized in the hospital setting. This study reports the outcomes of the B-Team (Buprenorphine-Team), a hospitalist-led interprofessional program created to identify hospitalized patients with OUD, initiate buprenorphine in the inpatient setting, and provide bridge prescription and access to outpatient treatment programs. During the first 2 years of the program, the B-Team administered buprenorphine therapy to 132 patients in the inpatient setting; 110 (83%) of these patients were bridged to an outpatient program. Of these patients, 65 patients (59%) were seen at their first outpatient appointment; 42 (38%) attended at least one subsequent appointment 1 to 3 months after discharge from the hospital; 29 (26%) attended at least one subsequent appointment between 3 and 6 months after discharge; and 24 (22%) attended at least one subsequent appointment after 6 months. This model is potentially replicable at other hospitals because it does not require dedicated addiction medicine expertise.
尽管有证据表明，治疗阿片类药物使用障碍（OUD）患者的药物可降低死亡率并提高门诊成瘾治疗的参与度，但这些救命药物在医院环境中的使用不足。本研究报告了 B 团队（丁丙诺啡团队）的结果，该团队由医院医生领导，是一个跨专业团队，旨在确定患有 OUD 的住院患者，在住院环境中启动丁丙诺啡治疗，并提供桥接处方和获得门诊治疗计划的途径。在该计划的头 2 年中，B 团队在住院环境中为 132 名患者提供了丁丙诺啡治疗；其中 110 名（83%）患者被转介到门诊治疗计划。在这些患者中，有 65 名（59%）患者在首次门诊就诊时就诊；42 名（38%）在出院后 1 至 3 个月至少就诊一次；29 名（26%）在出院后 3 至 6 个月至少就诊一次；24 名（22%）在出院后 6 个月后至少就诊一次。由于该模型不需要专门的成瘾医学专业知识，因此在其他医院中具有潜在的可复制性。
