West Virginia University School of Medicine, Morgantown, WV 26506, United States of America.
West Virginia Clinical and Translational Science Institute, Morgantown, WV 26506, United States of America.
J Subst Abuse Treat. 2022 May;136:108687. doi: 10.1016/j.jsat.2021.108687. Epub 2021 Dec 8.
This study evaluates if social distancing measures instituted during the novel coronavirus SARS-CoV-2 (COVID-19) pandemic were associated with a reduction in Medication for Opioid Use Disorder (MOUD) prescribing in West Virginia. The COVID-19 pandemic necessitated the quick implementation of public health interventions such as social distancing. This led to the use of telemedicine in the clinical setting however implementing telemedicine involves system level and infrastructure level changes within a healthcare environment. This could cause a barrier to MOUD delivery as it is often provided concomitantly with other face to face substance use and mental health services. The purpose of this study is to determine whether social distancing was associated with a reduction in MOUD prescribing in West Virginia, with the goal of adding to the knowledge of how COVID-19 and COVID-19-related mitigation strategies have impacted patients with OUD.
Prescription monitoring data were requested from the West Virginia Board of Pharmacy. We applied interrupted time series modeling to investigate MOUD prescribing practices before and after social distancing took effect. Gabapentin prescriptions were utilized as a control for comparison.
Our study assessed state-wide buprenorphine and Suboxone prescriptions as compared to a control medication and found an increase in dosage of both medications and an increase in number of buprenorphine prescriptions, but a small decrease in buprenorphine/naloxone prescription number related to the dates of implementation of social distancing. Taken together, overall this indicates an increase in prescription number of MOUD prescriptions as well as an increase in dosage.
This study suggests that social distancing measures were associated with an increase in both the number of MOUD prescriptions and the number of doses in each prescription. Significant alterations to MOUD delivery in the clinical setting were implemented in a short timeframe with the COVID-19 pandemic. Understanding the implementation of clinical measures to accommodate social distancing measures may provide benefit to transformation of future delivery of MOUD.
本研究评估了新型冠状病毒 SARS-CoV-2（COVID-19）大流行期间实施的社交距离措施是否与西弗吉尼亚州减少阿片类药物使用障碍（MOUD）处方有关。COVID-19 大流行需要快速实施公共卫生干预措施，如社交距离。这导致在临床环境中使用远程医疗，但实施远程医疗需要医疗环境中的系统级和基础设施级别的改变。这可能成为 MOUD 提供的障碍，因为它通常与其他面对面的药物使用和心理健康服务同时提供。本研究的目的是确定社交距离是否与西弗吉尼亚州 MOUD 处方减少有关，旨在增加对 COVID-19 和 COVID-19 相关缓解策略如何影响阿片类药物使用障碍患者的认识。
从西弗吉尼亚州药剂师委员会请求处方监测数据。我们应用中断时间序列模型来研究社交距离生效前后 MOUD 处方实践。利用加巴喷丁处方作为对照进行比较。
我们的研究评估了全州范围内的丁丙诺啡和 Suboxone 处方与对照药物，并发现两种药物的剂量增加，丁丙诺啡处方数量增加，但由于实施社交距离的日期，丁丙诺啡/纳洛酮处方数量略有减少。总的来说，这表明 MOUD 处方数量增加，剂量也增加。
这项研究表明，社交距离措施与 MOUD 处方数量和每个处方的剂量增加都有关。在 COVID-19 大流行期间，在短时间内对 MOUD 的临床交付进行了重大改变。了解临床措施的实施以适应社交距离措施可能有助于未来 MOUD 交付的转型。
