通过移动医疗单元提供治疗阿片类药物使用障碍的药物：范围综述。

Provision of medications to treat opioid use disorder via a mobile health unit: A scoping review.

机构信息

Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA; Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA.

Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA.

出版信息

J Subst Use Addict Treat. 2024 Sep;164:209431. doi: 10.1016/j.josat.2024.209431. Epub 2024 Jun 7.

DOI:10.1016/j.josat.2024.209431

PMID:38852822

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11300152/

Abstract

INTRODUCTION

Mobile health units (MHUs) provide a variety of low-barrier services to populations that face systemic barriers to healthcare access. However, MHUs are not a common delivery method for medications to treat opioid use disorder (MOUD), and, of these, there is no consensus regarding MHU targeted objectives and outcomes. This scoping review seeks to summarize the state of the literature examining the delivery of MOUD by MHUs in the United States.

METHODS

A search of PubMed, PsycInfo, and CINAHL on February 21, 2023, found 223 articles. Two authors completed title and abstract and full text reviews and extracted data relevant to intervention and study design, program objectives, and study outcomes. Ten articles fit the study's inclusion criteria (nine total interventions).

RESULTS

Of the 10 studies, six were cohort designs, three were cross-sectional (one with qualitative interviews), and one study conducted qualitative interviews only. Most studies were located in the Northeastern United States. MHU interventions primarily aimed to provide MOUD and to retain populations in treatment. Two interventions aimed to engage patients and then transfer them to fixed-site MOUD providers. Across four interventions that provided buprenorphine, 1- and 3-month retention rates varied from 31.6 % to 72.3 % and 26.2 % to 58.5 %, respectively. Qualitative interviews found that MOUD delivery from the MHU was characterized by less stigma/judgment and greater privacy compared to fixed-site, and it was flexible and low-barrier. MHUs were reportedly underutilized by the target populations, suggesting a lack of awareness from community members with opioid use disorder.

CONCLUSIONS

MHUs that deliver MOUD are both under-provided and -utilized. Future research should continue to assess MOUD provision from MHUs with an emphasis on robust study design, application to other formulations of MOUD, and evaluation of outcomes such as participant satisfaction and key informant perceived challenges.

REGISTRATION

Submitted to Open Science Framework (OSF) Repository on February 6, 2023.

摘要

简介

移动医疗单位（MHU）为那些面临医疗保健获取系统障碍的人群提供各种低门槛服务。然而，MHU 并不是治疗阿片类药物使用障碍（MOUD）药物的常见提供方式，而且在这些方式中，对于 MHU 的目标和结果还没有共识。本范围综述旨在总结美国使用 MHU 提供 MOUD 的文献状况。

方法

2023 年 2 月 21 日，通过 PubMed、PsycInfo 和 CINAHL 进行了搜索，共找到 223 篇文章。两名作者完成了标题和摘要以及全文审查，并提取了与干预和研究设计、项目目标和研究结果相关的数据。有 10 篇文章符合研究纳入标准（共 9 项干预措施）。

结果

在 10 项研究中，有 6 项为队列设计，3 项为横断面研究（其中 1 项进行了定性访谈），1 项仅进行了定性访谈。大多数研究都位于美国东北部。MHU 干预措施主要旨在提供 MOUD 并使患者继续接受治疗。两项干预措施旨在使患者参与进来，然后将他们转移到固定地点的 MOUD 提供者处。在四项提供丁丙诺啡的干预措施中，1 个月和 3 个月的保留率分别为 31.6%至 72.3%和 26.2%至 58.5%。定性访谈发现，与固定地点相比，从 MHU 提供 MOUD 的特点是较少的耻辱/判断和更大的隐私，而且更加灵活和低门槛。据报道，目标人群对 MHU 的利用率较低，这表明社区中患有阿片类药物使用障碍的患者对 MHU 的认识不足。