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以青少年为中心的阿片类激动剂治疗:一项新型综合青少年服务项目中,对青少年特征和阿片类激动剂治疗参与模式的回顾性图表分析研究结果。

Informing youth-centred opioid agonist treatment: Findings from a retrospective chart review of youths' characteristics and patterns of opioid agonist treatment engagement in a novel integrated youth services program.

机构信息

Foundry North Shore, North Vancouver, British Columbia, Canada.

Foundry Central Office, Vancouver, British Columbia, Canada.

出版信息

Early Interv Psychiatry. 2023 Oct;17(10):1028-1037. doi: 10.1111/eip.13446. Epub 2023 May 31.

Abstract

AIM

Youth ages 12-24 account for approximately 20% of overdoses and yet are poorly reached by opioid agonist treatment (OAT), the most widely recommended treatment for opioid use disorder (OUD). This study contributes to understanding this critical gap by describing youths' patterns of OAT engagement at a novel integrated youth-specific OAT program.

METHODS

A retrospective chart review was carried out on electronic medical records of n = 23 youth with OUD accessing a community-based integrated youth services (IYS) centre. Data abstraction focused on four domains: sociodemographic, social determinants of health, patterns of OAT engagement, and other services utilized.

RESULTS

Youths' mean age was 22.6 years (SD = 2.1), with a mean age of first opioid use of 17.4 (SD = 2.7). Youth reported extensive histories of adverse childhood experiences, concurrent mental and physical health complications, and poly-substance use. All youth were offered OAT and 83% initiated treatment with buprenorphine/naloxone, methadone, or slow-release oral morphine. Among those initiating OAT, 42.1% were considered stable on OAT.

CONCLUSIONS

To our knowledge, this is the first empirical study to describe youths' OAT engagement in an integrated youth-specific OAT program. Our findings demonstrated that a high proportion of youth with OUD initiated OAT in this novel program with varying degrees of OAT stability. These findings can be used to inform the development and implementation of youth-specific and integrated OAT. To account for the novelty of this area of study and small sample sizes, future collaborative efforts across IYS initiatives should be considered, including mixed method approaches to understand outcomes and experiences.

摘要

目的

12-24 岁的年轻人约占过量用药者的 20%,但他们接受阿片类激动剂治疗(OAT)的比例很低,而 OAT 是治疗阿片类使用障碍(OUD)最广泛推荐的方法。本研究通过描述年轻人在一个新颖的综合性青年特定 OAT 项目中参与 OAT 的模式,有助于了解这一关键差距。

方法

对 23 名患有 OUD 并接受基于社区的综合性青年服务(IYS)中心服务的年轻人的电子病历进行了回顾性图表审查。数据提取重点关注四个领域:社会人口统计学、健康的社会决定因素、OAT 参与模式以及其他利用的服务。

结果

年轻人的平均年龄为 22.6 岁(SD=2.1),首次使用阿片类药物的平均年龄为 17.4 岁(SD=2.7)。年轻人报告了广泛的不良童年经历、并发的精神和身体健康并发症以及多种物质使用。所有年轻人都被提供了 OAT,83%的人开始接受丁丙诺啡/纳洛酮、美沙酮或缓释口服吗啡治疗。在开始接受 OAT 的人中,42.1%的人被认为 OAT 稳定。

结论

据我们所知,这是第一项描述综合性青年特定 OAT 项目中年轻人 OAT 参与情况的实证研究。我们的研究结果表明,在这个新的项目中,相当一部分患有 OUD 的年轻人开始接受 OAT,并且 OAT 的稳定性程度不同。这些发现可以用于为青年特定和综合性 OAT 的制定和实施提供信息。考虑到这一研究领域的新颖性和样本量较小,应该考虑在 IYS 倡议之间开展未来的合作努力,包括采用混合方法来了解结果和经验。

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