The cascade of care for opioid use disorder among youth in British Columbia, 2018
The cascade of care for opioid use disorder among youth in British Columbia, 2018
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DOI：
10.1016/j.jsat.2021.108404
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发表时间：
2021-04-18
影响因子：
3.9
通讯作者：
Nosyk, Bohdan
中科院分区：
文献类型：
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作者：
Krebs, Emanuel;Min, Jeong E.;Nosyk, Bohdan
背景：治疗阿片类药物使用障碍 (MOUD) 的药物与死亡率风险的大幅降低相关，美国和加拿大的指南建议将其作为阿片类药物使用障碍 (OUD) 青少年可用治疗方案的一部分。我们估算了 2018 年加拿大不列颠哥伦比亚省 (BC) 所有青少年 (12-18 岁) 和年轻人 (19-24) OUD 护理的级联。方法：利用六个卫生管理数据库的省级链接，我们将 OUD 青少年分类为青少年 (12-18 岁) 或年轻人 (19-24)，与老年人 (> 25) 进行比较，并描述了已知影响参与医疗保健的关键因素。八阶段级联护理包括诊断为 OUD、曾经患有 MOUD、最近患有 MOUD、目前处于 MOUD 以及保持 MOUD 时间>1 个月、>3 个月、>12 个月、>24 个月。结果：截至 2018 年 9 月 30 日，我们确定了 4048 名被诊断患有 OUD 的青少年（占所有 OUD 患者的 6.3%）。大多数是 19-24 岁的年轻人（n = 3602；占所有青年的 89.0%），其中大多数是男性（n = 1984；55.1%）。相比之下，被诊断患有 OUD 的青少年（n = 446；占所有青少年的 11.0%）大多数为女性（n = 287；64.4%）。与青少年相比，被诊断患有 OUD 的年轻人中有更多曾经参与过 MOUD（71.4% vs. 36.5%）、目前正在接受 MOUD（29.3% vs. 16.8%）以及接受护理超过 1 年（8.6% vs. 2.0%）。结论：在不列颠哥伦比亚省的医疗保健机构中，被诊断患有 OUD 的 12-24 岁青少年中，很大一部分接受了 MOUD，但持续参与的情况很少，特别是对于青少年而言。青少年的长期治疗计划需要考虑在适当的时候将 MOUD 纳入定制的、青少年友好型服务的一部分。
Background: Medication for opioid use disorder (MOUD) is associated with substantial reductions in the risk of mortality, and American and Canadian guidelines recommend it as part of the full range of available treatments for youth with opioid use disorder (OUD). We estimated the OUD cascade of care for all adolescents (ages 12-18) and young adults (19-24) with OUD in British Columbia, Canada (BC) in 2018. Methods: Using a provincial-level linkage of six health administrative databases, we classified youth with OUD as adolescents (ages 12-18) or young adults (19-24) to compare with older adults (>25) and described key factors known to influence engagement in health care. The eight-stage cascade of care included diagnosed with OUD, ever engaged in MOUD, recently in MOUD, currently in MOUD, and retained in MOUD for >1 month, >3 months, >12 months, >24 months. Results: We identified 4048 youth diagnosed with OUD as of September 30, 2018 (6.3% of all people with OUD). Most were young adults, aged 19-24 (n = 3602; 89.0% of all youth), a majority of whom were males (n = 1984; 55.1%). In contrast, adolescents diagnosed with OUD (n = 446; 11.0% of all youth) were mostly females (n = 287; 64.4%). Compared to adolescents, there were more young adults diagnosed with OUD ever engaged in MOUD (71.4% v. 36.5%), currently on MOUD (29.3% v. 16.8%), and retained in care for >1 year (8.6% v. 2.0%). Conclusions: A high proportion of youth aged 12-24 diagnosed with OUD in a health care setting in British Columbia received MOUD yet continued engagement is infrequent, particularly for adolescents. Long-term treatment plans for youth need to consider including MOUD when appropriate as part of tailored, youthfriendly services.