Medication Treatment and Health Care Use Among Adolescents With Opioid Use Disorder in Ohio
Medication Treatment and Health Care Use Among Adolescents With Opioid Use Disorder in Ohio
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DOI：
10.1016/j.jadohealth.2020.01.016
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发表时间：
2020-07-01
影响因子：
7.6
通讯作者：
Chisolm, Deena J.
中科院分区：
文献类型：
--
作者：
Chavez, Laura J.;Bonny, Andrea E.;Chisolm, Deena J.
阿片类药物流行影响青少年和成人，过量死亡继续上升。两种药物治疗（丁丙诺啡和纳洛酮）在办公室环境中有效治疗阿片类药物使用障碍（OUD），但很少用于青少年。本研究描述了药物治疗OUD和其他护理收到的青少年OUD在一个国家的阿片类epidemies.Methods的中心：这项回顾性队列研究包括青少年（年龄12-18岁）参加俄亥俄州医疗补助与索引OUD诊断（2012年8月1日，2016年5月31日）。分析描述了在OUD诊断后3个月内接受OUD药物治疗、医疗保健（普通门诊、行为健康、住院和急诊）和其他药物治疗（注意缺陷/多动障碍、抗抑郁药、抗精神病药、苯二氮卓类药物和阿片类镇痛药）的青少年比例。按年龄组（12-15岁和16-18岁）比较结果：在参加医疗补助的626,508名青少年中，2,097人符合纳入标准。总体而言，4.6%的患者在OUD诊断后3个月内接受了OUD药物治疗，而9.8%的患者在OUD诊断后3个月内接受了阿片类镇痛药治疗。年龄较大的青少年接受OUD药物治疗的比例显著高于年龄较小的青少年（5.9% vs. 1.2%; p <0.001），而年龄较小的青少年接受注意力缺陷/多动障碍药物、抗抑郁药和抗精神病药的比例较高。两个年龄组中接受苯二氮卓类药物治疗的青少年比例均较低（2.4%和3.6%）。在3个月后的OUD诊断，48.5%的青少年有一般的医疗门诊就诊，29%接受门诊行为health service.Conclusions：虽然有很大比例的青少年与OUD有后续访问门诊设置，很少接受药物治疗OUD。(C)2020由Elsevier Inc.出版。代表青少年健康和医学协会。
Purpose: The opioid epidemic impacts both adolescents and adults, and overdose deaths continue to rise. Two medication treatments (buprenorphine and naltrexone) are effective for treating opioid use disorder (OUD) in office-based settings but are seldom prescribed to adolescents. The present study describes medication treatment for OUD and other care received by adolescents with OUD in a state at the center of the opioid epidemic.Methods: This retrospective cohort study included adolescents (aged 12-18 years) enrolled in Ohio Medicaid with an index OUD diagnosis (August 1, 2012, to May 31, 2016). Analyses describe the proportion of adolescents who received medication for OUD, health care (general medical outpatient, behavioral health, hospitalization, and emergency department), and other medications (attention deficit/hyperactivity disorder, antidepressants, antipsychotics, benzodiazepines, and opioid analgesics) within 3 months after OUD diagnosis. The results are compared by age group (12-15 and 16-18 years).Results: Among 626,508 adolescents enrolled in Medicaid, 2,097 met inclusion criteria. Overall, 4.6% received medication for OUD, whereas 9.8% received an opioid analgesic, within 3 months after OUD diagnosis. The proportion of older adolescents receiving medication for OUD was significantly higher than younger adolescents (5.9% vs. 1.2%; p < .001), whereas a higher proportion of younger adolescents received attention deficit/hyperactivity disorder medications, antidepressants, and antipsychotics. Low proportions of adolescents in both age groups received benzodiazepines (2.4% and 3.6%). During the 3 months after OUD diagnosis, 48.5% of adolescents had general medical outpatient visits, and 29% received outpatient behavioral health services.Conclusions: Although a large proportion of adolescents with OUD have subsequent visits in outpatient settings, few receive medications to treat OUD. (C) 2020 Published by Elsevier Inc. on behalf of Society for Adolescent Health and Medicine.