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在新冠疫情期间,一家联邦合格医疗中心(FQHC)的试点药师参与实践模式下,影响药物辅助康复(MAR)启动和维持的因素

Factors Affecting Initiation and Retention of Medication-Assisted Recovery (MAR) within a Pilot Pharmacist-Involved Practice Model at a Federally Qualified Healthcare Center (FQHC) during the COVID-19 Pandemic.

作者信息

Nguyen Tiffany, Cheetham Thomas Craig, Fawaz Souhiela, Beuttler Richard, Xavioer Sharon

机构信息

Department of Pharmacy Administration, Institute for Health Equity, AltaMed Health Services, Los Angeles, CA 90040, USA.

Department of Pharmacy Practice, Chapman University School of Pharmacy, Irvine, CA 92618, USA.

出版信息

Healthcare (Basel). 2023 May 11;11(10):1393. doi: 10.3390/healthcare11101393.

Abstract

BACKGROUND

During the COVID-19 pandemic, opioid-related overdose deaths increased. Although Medication-Assisted Treatment or Recovery (MAT or MAR) is available, initiation and retention rates vary. The goal of this study was to evaluate clinical, demographic, and Social Determinant of Health factors affecting MAR initiation, on-time initiation of medications, and successful retention in the program. The secondary goal was to evaluate the impact of a novel interprofessional practice model incorporating pharmacists.

METHODS

A retrospective analysis was conducted using electronic health record data from a pilot MAR Program initiated within a California Federally Qualified Healthcare Center.

RESULTS

From September 2019 to August 2020, 48 patients enrolled into the program. On-time initiation of medications occurred in 68% of patients and average program retention was 96.4 ± 95.8 days. Patients currently using opioids ( = 0.005) and those receiving supportive medications ( = 0.049) had lower odds of on-time MAR initiation. There were no statistically significant factors associated with successful retention in the program. The number of visits with members of the interprofessional team did not significantly affect on-time initiation or successful retention.

CONCLUSIONS

Current opioid use and receipt of supportive medications were associated with lower on-time medication initiation. Further studies are warranted to explore additional factors which may affect initiation and retention.

摘要

背景

在新冠疫情期间,与阿片类药物相关的过量用药死亡人数有所增加。尽管有药物辅助治疗或康复(MAT或MAR)可用,但启动率和留存率各不相同。本研究的目的是评估影响MAR启动、按时开始用药以及在该项目中成功留存的临床、人口统计学和健康社会决定因素。次要目标是评估纳入药剂师的新型跨专业实践模式的影响。

方法

使用加利福尼亚州一家联邦合格医疗中心启动的试点MAR项目的电子健康记录数据进行回顾性分析。

结果

2019年9月至2020年8月,48名患者加入该项目。68%的患者按时开始用药,项目平均留存时间为96.4±95.8天。目前使用阿片类药物的患者(P = 0.005)和接受支持性药物治疗的患者(P = 0.049)按时启动MAR的几率较低。没有与该项目成功留存相关的统计学显著因素。与跨专业团队成员的就诊次数对按时启动或成功留存没有显著影响。

结论

当前阿片类药物的使用和支持性药物的接受与较低的按时用药启动率相关。有必要进一步研究探索可能影响启动和留存的其他因素。

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本文引用的文献

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Racial and Ethnic Disparities in Medication-Assisted Treatment: Evidence from Louisiana Medicaid During the COVID-19 Pandemic.
J Gen Intern Med. 2023 Jan;38(1):266-268. doi: 10.1007/s11606-022-07893-8. Epub 2022 Nov 7.

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