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新冠疫情对物质使用障碍治疗的影响:利用真实世界数据研究面对面干预和远程医疗干预对治疗结果的影响。

Impact of COVID-19 on Substance Use Disorder Treatment: Examining the Influence of In-Person and Telehealth Intervention on Outcomes Using Real-World Data.

作者信息

Mancheño-Velasco Cinta, Narváez-Camargo Marta, Dacosta-Sánchez Daniel, de la Rosa-Cáceres Ana, Lozano Óscar M

机构信息

Department of Clinical and Experimental Psychology, University of Huelva, 21071 Huelva, Spain.

Natural Resources, Health and Environment, University of Huelva, 21071 Huelva, Spain.

出版信息

Healthcare (Basel). 2025 Jan 6;13(1):84. doi: 10.3390/healthcare13010084.

DOI:10.3390/healthcare13010084
PMID:39791691
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11720626/
Abstract

: The COVID-19 health crisis challenged healthcare systems around the world, leading to restrictions in access to face-to-face healthcare services, and forcing rapid adaptation to telehealth services. At present, there is a gap in the functioning of this adaptation in drug-dependence centres. The present study analyses, over four years, care indicators on the care modality (face-to-face vs. hybrid), the patient profile and the impact on retention in treatment. : Retrospective observational study with data collected between 14 March 2019 and 21 June 2023. The electronic health records of 44,930 patients were analysed according to different moments and selected based on the different health measures imposed by the COVID-19 pandemic. Patients were classified according to whether they received an in-person or hybrid intervention. Bivariate statistics and logistic regression analysis were applied. : The trend over time shows an increase in the number of patients seen in addiction centres. However, no notable changes within the in-person care modality and a modest increase in telehealth services are observed. Telehealth is primarily used among patients with opiate addiction, as well as with those with comorbid mental disorders. Logistic regression analysis shows that patients in a hybrid modality are more likely to remain in treatment. : Results show that hybrid care is associated with higher patient retention rates. Despite this, different profiles are mostly treated with in-person interventions rather than hybrid modalities. Future studies should explore how to generalise personalised hybrid care among SUD patients considering factors such as patients' educational level, employment status or accessibility to mental health services.

摘要

新冠疫情引发的健康危机给全球医疗系统带来了挑战,导致面对面医疗服务的获取受到限制,并迫使迅速适应远程医疗服务。目前,药物依赖治疗中心在这种适应过程的运作方面存在差距。本研究在四年时间里分析了关于护理模式(面对面与混合式)、患者概况以及对治疗留存率影响的护理指标。

回顾性观察研究,收集了2019年3月14日至2023年6月21日期间的数据。根据不同时期对44930名患者的电子健康记录进行分析,并根据新冠疫情实施的不同健康措施进行筛选。患者根据接受面对面干预还是混合式干预进行分类。应用了双变量统计和逻辑回归分析。

随时间的趋势显示,戒毒中心就诊患者数量有所增加。然而,在面对面护理模式内未观察到显著变化,远程医疗服务有适度增加。远程医疗主要用于阿片类成瘾患者以及患有合并精神障碍的患者。逻辑回归分析表明,采用混合模式的患者更有可能继续接受治疗。

结果表明,混合式护理与更高的患者留存率相关。尽管如此,不同类型的患者大多接受面对面干预而非混合模式。未来的研究应探索如何考虑患者的教育水平、就业状况或获得心理健康服务的可及性等因素,在物质使用障碍患者中推广个性化的混合式护理。

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本文引用的文献

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Gender differences in receipt of telehealth versus in person behavioral therapy, medication for opioid use disorder (MOUD), and 90-day MOUD retention during the pandemic: A retrospective veteran cohort study.疫情期间,接受远程医疗与面对面行为治疗、阿片类药物使用障碍药物治疗(MOUD)以及 90 天 MOUD 保留率的性别差异:一项回顾性退伍军人队列研究。
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