Division of General Internal Medicine, Department of Medicine, University of Washington, Seattle, Washington, USA.
School of Medicine, University of Washington, Seattle, Washington, USA.
Subst Abus. 2022 Dec;43(1):1308-1316. doi: 10.1080/08897077.2022.2095078.
: People with opioid use disorder (OUD) are increasingly started on buprenorphine in the hospital, yet many patients do not attend outpatient buprenorphine care after discharge. Peer providers, people in recovery themselves, are a growing part of addiction care. We examine whether patients who received a low-intensity, peer-delivered intervention during hospitalization had a greater rate of linking with outpatient buprenorphine care relative to those not seen by a peer. : This was a retrospective cohort study of adults with OUD who were started on buprenorphine during hospitalization. The primary outcome was receipt of a buprenorphine prescription within 30 days of discharge. Secondary outcomes included attendance at a follow-up visit with a buprenorphine provider within 30 days and hospital readmission within 90 days. Modified Poisson regression analyses tested for differences in the rate ratios (RR) of each binary outcome for patients who were versus were not seen by a peer provider. Peer notes in the electronic health record were reviewed to characterize peer activities. : 111 patients met the study inclusion criteria, 31.5% of whom saw a peer provider. 55.0% received a buprenorphine prescription within 30 days of hospital discharge. Patients with versus without peer provider encounters did not significantly differ in the rates of receiving a buprenorphine prescription (RR = 1.06, 95% CI: 0.74-1.51), hospital readmission (RR = 1.45, 95% CI: 0.80-2.64), or attendance at a buprenorphine follow-up visit (RR = 1.03, 95% CI: 0.68-1.57). Peers most often listened to or shared experiences with patients (68.6% of encounters) and helped facilitate medical care (60.0% of encounters). : There were no differences in multiple measures of buprenorphine follow-up between patients who received this low-intensity peer intervention and those who did not. There is need to investigate what elements of peer provider programs contribute to patient outcomes and what outcomes should be assessed when evaluating peer programs.
：患有阿片类药物使用障碍（OUD）的人在医院越来越多地开始使用丁丙诺啡，但许多患者在出院后并未参加门诊丁丙诺啡治疗。同伴提供者是康复中的人，他们是成瘾治疗的重要组成部分。我们研究了在住院期间接受低强度、同伴提供的干预的患者与未接受同伴治疗的患者相比，与门诊丁丙诺啡治疗建立联系的比率是否更高。：这是一项回顾性队列研究，纳入了在住院期间开始使用丁丙诺啡的患有 OUD 的成年人。主要结局是在出院后 30 天内收到丁丙诺啡处方。次要结局包括在 30 天内与丁丙诺啡提供者进行随访就诊和在 90 天内再次住院。使用修正泊松回归分析比较了接受和未接受同伴提供者治疗的患者在每个二项结局的比率比值（RR）的差异。审查电子健康记录中的同伴记录，以描述同伴活动。：共有 111 名患者符合研究纳入标准，其中 31.5%的患者接受了同伴提供者的治疗。55.0%的患者在出院后 30 天内收到了丁丙诺啡处方。与未接受同伴提供者治疗的患者相比，接受丁丙诺啡处方的患者在接受丁丙诺啡处方的比率（RR=1.06，95%CI：0.74-1.51）、再次住院（RR=1.45，95%CI：0.80-2.64）或参加丁丙诺啡随访就诊（RR=1.03，95%CI：0.68-1.57）方面无显著差异。同伴提供者最常与患者倾听或分享经验（68.6%的接触）并帮助促进医疗保健（60.0%的接触）。：在接受这种低强度同伴干预的患者和未接受的患者之间，在丁丙诺啡随访的多项措施上没有差异。需要研究同伴提供者计划的哪些要素对患者结局有贡献，以及在评估同伴计划时应评估哪些结局。
