Discussing Drug Use With Health Care Providers Is Associated With Perceived Need and Receipt of Drug Treatment Among Adults in the United States: We Need to Talk.
Discussing Drug Use With Health Care Providers Is Associated With Perceived Need and Receipt of Drug Treatment Among Adults in the United States: We Need to Talk.
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DOI：
10.1097/mlr.0000000000001340
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发表时间：
2020-07
期刊：
影响因子：
3
通讯作者：
Martins SS
中科院分区：
文献类型：
--
作者：
Mauro PM;Samples H;Klein KS;Martins SS
尽管药物使用障碍（DUD）的公共卫生负担很高，但药物治疗利用率很低。在更广泛的卫生保健环境中，让有DUD风险的人参与可能会提高药物治疗的接受率。估计医疗保健提供者与过去一年药物使用者之间药物使用筛查/讨论的流行率，并评估药物使用筛查/讨论与药物治疗的感知需求和使用之间的相关性。我们分析了2015-2017年全国药物使用和健康调查的代表性横截面数据。样本包括报告去年药物使用和≥1次医疗保健访视的≥18岁成人。我们使用多项逻辑回归来测量药物使用筛选/讨论的相关性。总体而言，在符合DUD标准的成年人中，我们使用逻辑回归来估计药物使用筛选/讨论与1）过去一年药物治疗和2）感知治疗需求之间的关联。在全部样本（n= 21，505）中，34.50%报告未进行筛选/讨论，44.50%报告仅进行筛选，21.00%报告与提供者进行讨论。讨论与接受任何药物治疗（aOR=3.52 [2.66-4.65]）、专科药物治疗（aOR=4.13 [2.92-5.82]）和感知治疗需求（aOR=2.08 [1.21-3.59]）的几率显著较高相关。在DUD患者（n= 3，834; 15.69%）中，讨论与治疗使用相关，但与感知需求无关。与提供者讨论药物使用可能会影响人们对药物治疗需求和使用的看法，这表明人们参与成瘾治疗的潜在机会。解决在整个护理环境中讨论药物使用的障碍可以增加治疗使用，特别是在DUD患者中。
Drug treatment utilization is low despite a high public health burden of drug use disorders (DUDs). Engaging people at risk for DUDs across a broader range of health care settings may improve uptake of drug treatment. To estimate the prevalence of drug use screening/discussions between health care providers and individuals with past-year drug use, and to assess the associations between drug use screening/discussions and perceived need and use of drug treatment. We analyzed representative cross-sectional data from the 2015–2017 National Surveys on Drug Use and Health. The sample included adults ≥18 years reporting past-year drug use and ≥1 health care visit. We measured correlates of drug use screening/discussions using multinomial logistic regression. Overall and among adults meeting DUD criteria, we used logistic regression to estimate associations between drug use screening/discussions and 1) past-year drug treatment and 2) perceived need for treatment. In the full sample (n=21,505), 34.50% reported no screening/discussions, 44.50% reported screening only, and 21.00% reported discussions with providers. Discussions were associated with significantly higher odds of receiving any drug treatment (aOR=3.52 [2.66–4.65]), specialty drug treatment (aOR=4.13 [2.92–5.82]), and perceived treatment need (aOR=2.08 [1.21–3.59]). Among people with DUD (n=3,834; 15.69%), discussions were associated with treatment use, but not with perceived need. Discussing drug use with providers may impact people’s perceptions of drug treatment need and use, indicating potential opportunities to engage people in addiction treatment. Addressing barriers to discussing drug use across care settings could increase treatment use, particularly among people with DUD.