Access to Medications for Opioid Use Disorder and Associated Factors Among Adolescents and Young Adults: A Systematic Review.
Access to Medications for Opioid Use Disorder and Associated Factors Among Adolescents and Young Adults: A Systematic Review.
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DOI：
10.1001/jamapediatrics.2021.4606
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发表时间：
2022-03-01
期刊：
影响因子：
26.1
通讯作者：
Karamouzian, Mohammad
中科院分区：
文献类型：
--
作者：
Pilarinos, Andreas;Bromberg, Daniel J.;Karamouzian, Mohammad
持续的服药过量危机继续对青少年和青壮年造成不利影响，并已导致许多本可预防的死亡。治疗阿片使用障碍(MOUD)的药物，如美沙酮、丁丙诺啡和纳曲酮，有可能减少阿片类药物的使用和相关的危害；然而，有人担心阿片使用障碍患者无法获得这些可能挽救生命的药物。系统地回顾关于Moud获取及其相关因素的同行评议文献，以综合能够改善使用阿片类药物的AYA的Moud获取的策略。检索MEDLINE、Embase、CogcINFO、CINAHL、社会学摘要、科学网、全球学位论文和主题数据库，从数据库建立到2021年5月3日。英语、法语、俄语或西班牙语的同行评议研究评估了Moud的可用性、处方收据或启动情况，符合纳入条件。这项系统回顾确定了37项队列研究(n=17)、横断面研究(n=15)和定性研究(n=5)，涉及179 785个AYA(平均年龄24.4[3.9]岁；女性148779[85%]；白人67771[84%])，并检查了美沙酮(30个研究)、丁丙诺啡(26个研究)和纳曲酮(10个研究)的使用情况。研究结果强化了人们的担忧，即AYA不太可能使用Moud，并表明青少年更有可能接受纳曲酮或丁丙诺啡-纳洛酮的治疗，与年轻人相比，这两种药物滥用的可能性较低。这项审查还确定了与穆德机会相关的其他因素，包括刑事司法参与、居住在美国南部、生活在有限收入地区、黑人种族以及西班牙裔或拉丁裔族裔，提出了可以改进治疗服务的方法，以增加穆德机会并实现AYA的治疗目标。这项系统的审查发现，除了青少年和年轻人之间在获得Moud方面的差异外，AYA和非AYA人群之间在Moud获取方面也存在差距。考虑到现有临床指南建议在AYA中使用Moud，并鉴于阿片类药物中毒死亡人数不断增加，有必要通过减少Moud的障碍并在Moud的基础上向AYA提供连续的健康和社会支持，来改善AYA中Moud的获取。未来对如何在AYA中鼓励Moud摄取的研究可能会改善这一人群的治疗和健康结果。
The ongoing overdose crisis continues to adversely affect adolescents and young adults (AYAs) and has led to numerous preventable deaths. Medications for opioid use disorder (MOUD), such as methadone, buprenorphine, and naltrexone, have the potential to reduce opioid use and associated harms; however, there are concerns that AYAs lack access to these potentially life-saving medications. To systematically review peer-reviewed literature on MOUD access and associated factors to synthesize strategies that can improve MOUD access for AYAs who use opioids. The MEDLINE, Embase, PsycINFO, CINAHL, Sociological Abstracts, Web of Science, and Global Dissertations & Theses databases were searched from database inception until May 3, 2021. English, French, Russian, or Spanish peer-reviewed studies that evaluated the availability, prescription receipt, or initiation of MOUD were eligible for inclusion. This systematic review identified 37 cohort (n = 17), cross-sectional (n = 15), and qualitative (n = 5) studies that accounted for 179 785 AYAs (mean [SD] age, 24.4 [3.9] years; 148 779 [85%] were female; 67 771 [84%] were White) and examined access to methadone (30 studies), buprenorphine (26 studies), and naltrexone (10 studies). Findings reinforce concerns that AYAs were less likely to access MOUD and suggest that adolescents were more likely to receive naltrexone or buprenorphine-naloxone, which have a lower potential for abuse, in comparison with young adults. This review also identified other factors that were associated with MOUD access, including criminal justice involvement, residing in the US South, living in a limited-income area, Black race, and Hispanic or Latino ethnicity, suggesting ways in which treatment services may be improved to increase MOUD access and meet the treatment goals of AYAs. This systematic review found gaps in MOUD access between AYAs and non-AYA populations in addition to differences in MOUD access between adolescents and young adults. Considering that existing clinical guidelines recommend the use of MOUD among AYAs, and in light of the increasing number of opioid toxicity deaths, there is a need to improve MOUD access among AYAs by reducing barriers to MOUD and providing AYAs with a continuum of health and social supports alongside MOUD. Future research into ways to encourage MOUD uptake among AYAs may improve the treatment and health outcomes for this population.
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影响因子：
7.6
作者：
Chavez, Laura J.;Bonny, Andrea E.;Chisolm, Deena J.
通讯作者：
Chisolm, Deena J.
影响因子：
3.5
作者：
Paino M;Aletraris L;Roman PM
通讯作者：
Roman PM
DOI：
10.1080/00952990.2017.1399403
发表时间：
2018
期刊：
The American journal of drug and alcohol abuse
影响因子：
--
作者：
Chang DC;Klimas J;Wood E;Fairbairn N
通讯作者：
Fairbairn N
影响因子：
5.1
作者：
Fagan, John;Naughton, Leena;Smyth, Bobby
通讯作者：
Smyth, Bobby
影响因子：
6.1
作者：
Bateman, Johanna;Gilvarry, Eilish;McArdle, Paul
通讯作者：
McArdle, Paul