评估一项全州范围内的政策，以改善急诊后过量用药后的护理和随后的治疗参与度。
Evaluation of a Statewide Policy to Improve Post-Overdose Care in Emergency Departments and Subsequent Treatment Engagement.
机构信息
Lead Research Scientist and Assistant Professor of the Practice of Epidemiology in the Department of Epidemiology at Brown University in Providence, Rhode Island.
Program Manager of the Substance Use Epidemiology Program at the Rhode Island Department of Health in Providence, Rhode Island.
出版信息
R I Med J (2013). 2023 Mar 1;106(2):34-39.
OBJECTIVE
To evaluate the impact of a statewide treatment standards policy for post-overdose emergency department (ED) care on services provided and subsequent treatment engagement.
METHODS
This pre-/post-study used electronic health record data and surveillance data from Rhode Island. Outcomes were compared for patients attending EDs for opioid overdose before (03/1/2015-02/28/2017) and after (04/01/2017-03/31/2021) policy release.
RESULTS
Overall, 2,134 patients attended 2,891 ED visits for opioid overdose. Compared to pre-policy, visits post-policy more often included initiation of buprenorphine in or from the ED (<1% vs. 3%, p<0.01), provision of a take-home naloxone kit or prescription (41% vs. 58%, p<0.01), and referral to treatment (0% vs. 34%, p<0.01). Provision of behavioral counseling in the ED and initiation of treatment within 30 days of the visit were similar during the two periods.
CONCLUSIONS
Statewide post-overdose treatment standards may improve provision of some ED services. Additional strategies are needed to improve subsequent treatment engagement.
目的
评估全州范围内针对阿片类药物过量急诊（ED）治疗后护理的治疗标准政策对所提供服务及后续治疗参与的影响。
方法
本研究采用了电子健康记录数据和来自罗德岛的监测数据，对政策发布前（2015 年 3 月 1 日至 2017 年 2 月 28 日）和发布后（2017 年 4 月 1 日至 2021 年 3 月 31 日）接受 ED 治疗的阿片类药物过量患者的结局进行了比较。
结果
总体而言，共有 2134 名患者在 2891 次 ED 就诊中因阿片类药物过量。与政策发布前相比，政策发布后就诊时更常包括在 ED 中或从 ED 开始使用丁丙诺啡（<1% vs. 3%，p<0.01）、提供家庭用纳洛酮套件或处方（41% vs. 58%，p<0.01）以及转介至治疗（0% vs. 34%，p<0.01）。ED 中提供行为咨询和在就诊后 30 天内开始治疗在两个时期相似。
结论
全州范围内的阿片类药物过量后治疗标准可能会改善某些 ED 服务的提供。需要采取额外的策略来提高后续的治疗参与度。
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