为美沙酮诊所患者提供医疗服务：转诊与现场医疗服务
Providing medical care to methadone clinic patients: referral vs on-site care.
作者信息
Umbricht-Schneiter A, Ginn D H, Pabst K M, Bigelow G E
机构信息
Behavioral Pharmacology Research Unit, Johns Hopkins Medical School, Baltimore, Md.
出版信息
Am J Public Health. 1994 Feb;84(2):207-10. doi: 10.2105/ajph.84.2.207.
Abstract
OBJECTIVES
Intravenous drug users are at high risk for medical illness, yet many are medically underserved. Most methadone treatment programs have insufficient resources to provide medical care. The purpose of this study was to test the efficacy of providing medical care at a methadone clinic site vs referral to another site.
METHODS
Patients with any of four target medical conditions were randomized into an on-site group offered medical care at the methadone treatment clinic and a referred group offered medical care at a nearby clinic. Entry to treatment and use of medical services were analyzed.
RESULTS
Of 161 intravenous drug users evaluated, 75 (47%) had one or more of the target medical conditions. Fifty-one were randomized. In the on-site group (n = 25), 92% received medical treatment; in the referred group (n = 26), only 35% received treatment.
CONCLUSIONS
Providing medical care at a methadone treatment program site is more effective than the usual referral procedure and is a valuable public health intervention.
摘要
目的
静脉吸毒者面临较高的患病风险，但许多人在医疗服务方面未得到充分满足。大多数美沙酮治疗项目资源不足，无法提供医疗服务。本研究的目的是测试在美沙酮诊所提供医疗服务与转介到其他地点相比的疗效。
方法
患有四种目标医疗状况中任何一种的患者被随机分为在美沙酮治疗诊所接受医疗服务的现场组和在附近诊所接受医疗服务的转介组。对治疗的进入情况和医疗服务的使用情况进行了分析。
结果
在评估的161名静脉吸毒者中，75人（47%）患有一种或多种目标医疗状况。51人被随机分组。在现场组（n = 25）中，92%的人接受了医疗治疗；在转介组（n = 26）中，只有35%的人接受了治疗。
结论
在美沙酮治疗项目地点提供医疗服务比通常的转介程序更有效，是一项有价值的公共卫生干预措施。
相似文献
1
Providing medical care to methadone clinic patients: referral vs on-site care.为美沙酮诊所患者提供医疗服务：转诊与现场医疗服务
Am J Public Health. 1994 Feb;84(2):207-10. doi: 10.2105/ajph.84.2.207.
2
Tuberculin reactions among attendees at a methadone clinic: relation to infection with the human immunodeficiency virus.
Clin Infect Dis. 1994 Dec;19(6):1100-4. doi: 10.1093/clinids/19.6.1100.
3
Implementing methadone medical maintenance in community-based clinics: disseminating evidence-based treatment.在社区诊所实施美沙酮维持治疗：推广循证治疗
J Subst Abuse Treat. 2008 Oct;35(3):312-21. doi: 10.1016/j.jsat.2007.12.002. Epub 2008 Feb 21.
4
Day treatment versus enhanced standard methadone services for opioid-dependent patients: a comparison of clinical efficacy and cost.日间治疗与强化标准美沙酮服务对阿片类药物依赖患者的疗效比较及成本分析
Am J Psychiatry. 1999 Jan;156(1):27-33. doi: 10.1176/ajp.156.1.27.
5
Do mechanisms that link addiction treatment patients to primary care influence subsequent utilization of emergency and hospital care?将成瘾治疗患者与初级保健联系起来的机制是否会影响随后对急诊和医院护理的利用？
Med Care. 2006 Jan;44(1):8-15. doi: 10.1097/01.mlr.0000188913.50489.77.
6
Utilization of on-site primary care services by HIV-seropositive and seronegative drug users in a methadone maintenance program.在美沙酮维持治疗项目中，HIV血清阳性和血清阴性吸毒者对现场初级保健服务的利用情况。
Public Health Rep. 1993 Jul-Aug;108(4):492-500.
7
A women-only clinic for HIV, genitourinary medicine and substance misuse.一家专为女性提供服务的诊所，提供艾滋病、性传播疾病及药物滥用方面的医疗服务。
Genitourin Med. 1992 Dec;68(6):386-9. doi: 10.1136/sti.68.6.386.
8
[More of the Surinam and Antilles drug addicts involved in the GG&GD (Community Medical and Health Service) methadone program in Amsterdam should be referred to the family physician for their methadone maintenance].在阿姆斯特丹参与GG&GD（社区医疗与健康服务）美沙酮项目的苏里南和安的列斯群岛吸毒成瘾者中，更多人应被转介给家庭医生进行美沙酮维持治疗。
Ned Tijdschr Geneeskd. 1997 Feb 8;141(6):288-91.
9
On-site medical care in methadone maintenance: associations with health care use and expenditures.美沙酮维持治疗中的现场医疗护理：与医疗保健利用和支出的关联
J Subst Abuse Treat. 2007 Mar;32(2):143-51. doi: 10.1016/j.jsat.2006.07.008. Epub 2006 Oct 27.
10
Effects of lower-cost incentives on stimulant abstinence in methadone maintenance treatment: a National Drug Abuse Treatment Clinical Trials Network study.低成本激励措施对美沙酮维持治疗中兴奋剂戒断的影响：一项国家药物滥用治疗临床试验网络研究。
Arch Gen Psychiatry. 2006 Feb;63(2):201-8. doi: 10.1001/archpsyc.63.2.201.
引用本文的文献
1
Yoga and Physical Therapy for Chronic Pain and Opioid Use Disorder Onsite in an Opioid Treatment Program: A Randomized Controlled Trial.阿片类药物治疗项目中针对慢性疼痛和阿片类药物使用障碍的现场瑜伽与物理治疗：一项随机对照试验
Subst Use Addctn J. 2025 Jan;46(1):175-183. doi: 10.1177/29767342241265929. Epub 2024 Aug 1.
2
Integrated care van delivery of evidence-based services for people who inject drugs: A cluster-randomized trial.基于证据的综合关怀车服务在注射吸毒者中的应用：一项集群随机试验。
Addiction. 2024 Jul;119(7):1276-1288. doi: 10.1111/add.16486. Epub 2024 Apr 1.
3
Together in care: Lessons learned at the intersection of integrated care, quality improvement, and implementation practice in opioid treatment programs.共同护理：阿片类药物治疗项目中综合护理、质量改进与实施实践交叉领域的经验教训。
Implement Res Pract. 2022 Nov 4;3:26334895221135265. doi: 10.1177/26334895221135265. eCollection 2022 Jan-Dec.
4
Economic, social, and clinic influences on opioid treatment program retention in Dar es Salaam, Tanzania: a qualitative study.坦桑尼亚达累斯萨拉姆的经济、社会和临床因素对阿片类药物治疗项目保留率的影响：一项定性研究。
Addict Sci Clin Pract. 2023 Mar 27;18(1):19. doi: 10.1186/s13722-023-00374-1.
5
Preliminary analysis of self-reported quality health indicators of patients on opioid agonist therapy at specialty and primary care clinics in Ukraine: A randomized control trial.乌克兰专科和初级保健诊所接受阿片类激动剂治疗患者自我报告的健康质量指标的初步分析：一项随机对照试验。
PLOS Glob Public Health. 2022 Nov 2;2(11):e0000344. doi: 10.1371/journal.pgph.0000344. eCollection 2022.
6
Healthcare utilization for somatic conditions among Swedish patients in opioid substitution treatment, with and without on-site primary healthcare.在有和没有现场初级保健的情况下，瑞典接受阿片类药物替代治疗的患者的躯体疾病的医疗保健利用情况。
BMC Health Serv Res. 2022 Jul 29;22(1):971. doi: 10.1186/s12913-022-08351-1.
7
Healthcare seeking among Swedish patients in opioid substitution treatment - a mixed methods study on barriers and facilitators.在阿片类物质替代治疗中寻求医疗保健的瑞典患者 - 关于障碍和促进因素的混合方法研究。
Subst Abuse Treat Prev Policy. 2022 Feb 5;17(1):8. doi: 10.1186/s13011-022-00434-w.
8
Healthcare Contacts Regarding Circulatory Conditions among Swedish Patients in Opioid Substitution Treatment, with and without On-Site Primary Healthcare.瑞典接受阿片类药物替代治疗的患者的循环系统状况的医疗保健联系人，有无现场初级保健。
Int J Environ Res Public Health. 2021 Apr 27;18(9):4614. doi: 10.3390/ijerph18094614.
9
Self-Rated Physical Health and Unmet Healthcare Needs among Swedish Patients in Opioid Substitution Treatment.瑞典接受阿片类药物替代治疗患者的自评身体健康状况与未满足的医疗保健需求
J Addict. 2019 Apr 15;2019:7942145. doi: 10.1155/2019/7942145. eCollection 2019.
10
The association between medical comorbidity and Healthcare Effectiveness Data and Information Set (HEDIS) measures of treatment initiation and engagement for alcohol and other drug use disorders.医疗共病与医疗保健效果数据和信息集（HEDIS）之间的关联，用于衡量酒精和其他药物使用障碍的治疗起始和参与情况。
Subst Abus. 2019;40(3):292-301. doi: 10.1080/08897077.2018.1545726. Epub 2019 Jan 24.
本文引用的文献
1
The effects of psychosocial services in substance abuse treatment.心理社会服务在药物滥用治疗中的作用。
JAMA. 1993 Apr 21;269(15):1953-9.
2
AIDS and addiction in New York City.纽约市的艾滋病与成瘾问题。
Am J Drug Alcohol Abuse. 1986;12(1-2):165-81. doi: 10.3109/00952998609083750.
3
Noncompliance in the treatment of endocarditis. The medical staff as co-conspirators.
Gen Hosp Psychiatry. 1988 May;10(3):197-201. doi: 10.1016/0163-8343(88)90019-9.
4
[AIDS epidemiology and prevention in i.v. drug addicts].
Soz Praventivmed. 1988;33(7):326-30. doi: 10.1007/BF02084298.
5
HIV infection among intravenous drug abusers in the United States and Europe.美国和欧洲静脉注射吸毒者中的艾滋病毒感染情况。
NIDA Res Monogr. 1988;80:7-17.
6
Primary care for patients with human immunodeficiency virus (HIV) infection in a methadone maintenance treatment program.
Ann Intern Med. 1989 Nov 1;111(9):761-3. doi: 10.7326/0003-4819-111-9-761.
7
Prevalence of HIV infection among intravenous drug users in the United States.美国静脉注射吸毒者中艾滋病毒感染的流行情况。
JAMA. 1989 May 12;261(18):2677-84.
8
Methadone treatment and acquired immunodeficiency syndrome.
JAMA. 1989;262(12):1664-8.
9
Comparison of chemiluminescent DNA probe to cell culture for the screening of Chlamydia trachomatis in a gynecology clinic population.
Obstet Gynecol. 1990 Jul;76(1):114-7.
10
Tuberculosis, AIDS, and i.v. drug abuse.
N J Med. 1990 May;87(5):413-5.
Zotero 插件