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丁丙诺啡提供者对于在农村和郊区基层医疗环境中扩大减少伤害服务的偏好:一份简短报告。

Buprenorphine provider preferences to expanding harm reduction services in rural and suburban primary care settings: a short report.

作者信息

Tofighi Babak, Franklin Neelufar Sarah, Wolf Ethan, Maria-Lekas Helen, Lewis Crystal Fuller

机构信息

New York State Office of Mental Health, Nathan S. Kline Institute for Psychiatric Research, Division of Social Solutions and Services Research.

New York University School of Medicine, Department of Population Health.

出版信息

J Subst Use. 2025 Feb 10. doi: 10.1080/14659891.2025.2460841.

DOI:10.1080/14659891.2025.2460841
PMID:40933807
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12419767/
Abstract

INTRODUCTION

The opioid overdose crisis continues to worsen in suburban and rural regions. Expanding harm reduction approaches in primary care offers a patient-centered approach to reduce opioid overdoses.

METHODS

We conducted a semi-structured survey among 26 buprenorphine prescribers to assess acceptability of office-based harm reduction strategies for people who use opioids (PWUOs) and expanding partnerships with community stakeholders to ensure low-threshold access to buprenorphine.

RESULTS

Respondents were mostly very or somewhat supportive of providing HIV testing (96.2%), information on opioid overdose prevention (100%), safe syringe disposal (100%) and use (100%), and referrals to free HIV testing (100%), social services (100%), naloxone sales in community pharmacies (96.2%) and partnering with pharmacists to facilitate referrals for patients requesting buprenorphine treatment (84.6%). Suggested strategies for enhancing care for PWUOs included addressing insurance-related barriers (e.g., prior authorization requirements, insufficient reimbursements), lifting of limits on patients prescribed buprenorphine, allowing for safe-injection sites, lifting urine drug testing requirements, integrating social services and mental health providers within primary care, and expanding the use of telebuprenorphine services.

CONCLUSION

Findings from this study suggest strong buprenorphine provider support for adopting harm reduction strategies in primary care and collaborating with community pharmacists to facilitate referrals for PWUOs.

摘要

引言

阿片类药物过量危机在郊区和农村地区持续恶化。在初级保健中扩大减少伤害的方法提供了一种以患者为中心的方法来减少阿片类药物过量。

方法

我们对26名丁丙诺啡处方医生进行了一项半结构化调查,以评估针对阿片类药物使用者(PWUOs)的基于办公室的减少伤害策略的可接受性,以及扩大与社区利益相关者的伙伴关系,以确保低门槛获得丁丙诺啡。

结果

受访者大多非常支持或有些支持提供艾滋病毒检测(96.2%)、阿片类药物过量预防信息(100%)、安全注射器处理(100%)和使用(100%),以及转介到免费艾滋病毒检测(100%)、社会服务(100%)、社区药房销售纳洛酮(96.2%),以及与药剂师合作以促进为请求丁丙诺啡治疗的患者进行转介(84.6%)。建议的加强对PWUOs护理的策略包括解决与保险相关的障碍(例如,预先授权要求、报销不足)、取消对丁丙诺啡处方患者的限制、允许设立安全注射点、取消尿液药物检测要求、在初级保健中整合社会服务和心理健康提供者,以及扩大丁丙诺啡远程服务的使用。

结论

本研究结果表明,丁丙诺啡提供者强烈支持在初级保健中采用减少伤害策略,并与社区药剂师合作以促进为PWUOs进行转介。

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本文引用的文献

1
Increasing buprenorphine access for veterans with opioid use disorder in rural clinics using telemedicine.利用远程医疗增加农村诊所中患有阿片类药物使用障碍的退伍军人的丁丙诺啡获取途径。
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Opioid-related mortality in rural America: Geographic heterogeneity and intervention strategies.美国农村地区阿片类药物相关死亡率:地理异质性与干预策略。
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Consensus statement on office-based treatment of opioid dependence using buprenorphine.关于使用丁丙诺啡在门诊治疗阿片类药物依赖的共识声明。
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