Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, NSW, Australia.
School of Public Health and Community Medicine, UNSW Sydney, Sydney, Australia.
BMC Public Health. 2024 Feb 2;24(1):349. doi: 10.1186/s12889-024-17827-0.
In April 2020, in response to the COVID-19 public health emergency, South Eastern Sydney Local Health District (SESLHD) Drug and Alcohol services modified their delivery of opioid dependency treatment (ODT) to reduce spread of COVID-19 and maintain continuity of care by increasing use of takeaway doses (TADs), transferring clients to local community pharmacies for dosing and encouraging the use of long-acting depot buprenorphine (LADB) which enabled once a month dosing.
This study was a retrospective longitudinal case-control study conducted from August 1st, to November 30th, 2021. Eligible clients were those admitted for treatment with SESLHD ODT Services prior to August 1st,2021 and who remained in treatment beyond November 30th, 2021. COVID-19 diagnoses were determined by a COVID-19 PCR and extracted from the electronic Medical Records (eMR) Discern Reporting Portal. Demographic, clinical and dosing related data were collected from eMR and the Australian Immunisation Register (AIR).
Clients attending SESLHD ODT services had significantly greater odds of acquiring COVID-19 than the NSW adult population at large (OR: 13.63, 95%CI: 9.64,18.88). Additionally, amongst SESLHD ODT clients, being of Aboriginal and Torres Strait Islander origin was associated with greater odds of acquiring COVID-19 (OR = 2.18, CI: 1.05,4.53); whilst being employed (OR = 0.06, CI:0.01,0.46), receiving doses at pharmacy (OR = 0.43, CI: 0.21,0.89), and being vaccinated (OR = 0.12, CI: 0.06,0.26) were associated with lower odds. Every additional day of attendance required for dosing was associated with a 5% increase in odds of acquiring COVID-19 (OR = 1.05, CI: 1.02,1.08).
Clients attending SESLHD ODT services are significantly more likely to acquire COVID-19 than the NSW population at large. Promoting vaccination uptake, transferring clients to pharmacy, and reducing the frequency of dosing (by use of takeaway doses or long-acting depot buprenorphine) are all potential methods to reduce this risk.
2020 年 4 月，为应对 COVID-19 公共卫生紧急事件，东南悉尼地方卫生区（SESLHD）的药物和酒精服务部门修改了阿片类药物依赖治疗（ODT）的提供方式，以减少 COVID-19 的传播并通过增加外带剂量（TAD）、将客户转移到当地社区药房进行剂量调整以及鼓励使用长效丁丙诺啡（LADB）来维持护理的连续性，这使得每月只需给药一次。
这是一项回顾性纵向病例对照研究，于 2021 年 8 月 1 日至 11 月 30 日进行。符合条件的客户是指在 2021 年 8 月 1 日之前在 SESLHD ODT 服务处接受治疗并在 2021 年 11 月 30 日之后仍在接受治疗的客户。COVID-19 的诊断是通过 COVID-19 PCR 确定的，并从电子病历（eMR）Discern 报告门户中提取。人口统计学、临床和剂量相关数据均从 eMR 和澳大利亚免疫登记册（AIR）中收集。
与新南威尔士州一般成年人相比，接受 SESLHD ODT 服务的客户感染 COVID-19 的可能性显著更高（OR：13.63，95%CI：9.64，18.88）。此外，在 SESLHD ODT 客户中，原住民和托雷斯海峡岛民的血统与感染 COVID-19 的可能性更大相关（OR=2.18，CI：1.05，4.53）；而就业（OR=0.06，CI：0.01，0.46）、在药房接受剂量（OR=0.43，CI：0.21，0.89）和接种疫苗（OR=0.12，CI：0.06，0.26）的可能性较低。每次剂量就诊需要增加一天，感染 COVID-19 的可能性就会增加 5%（OR=1.05，CI：1.02，1.08）。
与新南威尔士州一般人群相比，接受 SESLHD ODT 服务的客户感染 COVID-19 的可能性要高得多。提高疫苗接种率、将客户转移到药房以及减少剂量（通过使用外带剂量或长效丁丙诺啡）都可能降低这种风险。
