Impacts of the COVID-19 pandemic on healthcare access among patients receiving medication for opioid use disorder.
Impacts of the COVID-19 pandemic on healthcare access among patients receiving medication for opioid use disorder.
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DOI：
10.1016/j.drugalcdep.2021.108617
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发表时间：
2021-04-01
影响因子：
4.2
通讯作者：
Becker SJ
中科院分区：
文献类型：
--
作者：
Jacka BP;Janssen T;Garner BR;Yermash J;Yap KR;Ball EL;Hartzler B;Becker SJ
COVID-19大流行显著改变了阿片类药物治疗项目（OTP）的治疗交付，为阿片类药物使用障碍（MOUD）分发药物。我们的目的是确定MOUD患者的物质使用模式，并检查COVID-19对获得医疗保健的影响是否在亚组之间存在差异。这项分析被嵌入到一项3型混合试验中，该试验在大流行开始时招募了8个OTP的患者。入组患者在基线评估期间报告了过去30天使用多种药物。于2020年5月至7月重新联络的参与者完成了一项关于COVID-19相关对各个生活领域影响的调查。使用潜在类别分析，我们确定了患者亚组，然后检查了与医疗服务相关的一组负面和正面COVID-19影响的组间差异。在188名试验参与者中，135名（72%）完成了调查。潜在类别分析确定了三个MOUD患者亚组：最小使用（类别概率：0.25）;阿片类药物使用（类别概率：0.34）;和多种物质使用（类别概率：0.41）。与最低限度使用组相比，多种物质使用组报告的物质使用增加，难以获得无菌针头、纳洛酮和首选物质。阿片类药物使用组报告说，药物使用增加，难以获得他们首选的药物。在获得常规或专业医疗保健或药物方面没有显着的组间差异;或关注他们的健康。在COVID-19期间，许多MOUD患者报告了获得护理的挑战，特别是使用多种物质的患者的减少伤害服务。额外的努力，如提供环绕式支持，可能是必要的，以满足MOUD患者的需求。
The COVID-19 pandemic significantly altered treatment delivery for opioid treatment programs (OTPs) dispensing medications for opioid use disorder (MOUD). We aimed to identify patterns of substance use among MOUD patients and examine whether COVID-19-related impacts on access to healthcare varied across subgroups. This analysis was embedded within a type 3 hybrid trial that enrolled patients across eight OTPs at the start of the pandemic. Enrolled patients reported on past-30 day use of multiple substances during their baseline assessment. Participants re-contacted in May–July 2020 completed a survey about COVID-19-related impacts on various life domains. Using latent class analysis we identified patient subgroups, and then examined group differences on a set of negative and positive COVID-19 impacts related to healthcare access. Of the 188 trial participants, 135 (72 %) completed the survey. Latent class analysis identified three MOUD patient subgroups: minimal use (class probability: 0.25); opioid use (class probability: 0.34); and polysubstance use (class probability: 0.41). Compared to the minimal use group, the polysubstance use group reported increased substance use and difficulty accessing sterile needles, naloxone, and preferred substance. The opioid use group reported increased substance use and difficulty accessing their preferred substance. There were no significant group differences related to accessing routine or specialized healthcare or medication; or paying attention to their health. During COVID-19, many MOUD patients reported challenges accessing care, particularly harm reduction services for patients with polysubstance use. Additional efforts, like providing wraparound support, may be necessary to serve the needs of MOUD patients.
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DOI：
10.1080/10705511.2013.742377
发表时间：
2013-01
期刊：
Structural equation modeling : a multidisciplinary journal
影响因子：
--
作者：
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通讯作者：
Bray BC
影响因子：
12.7
作者：
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通讯作者：
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DOI：
10.1016/j.drugpo.2017.07.009
发表时间：
2017-11
期刊：
The International journal on drug policy
影响因子：
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作者：
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通讯作者：
Nosyk B
影响因子：
6
作者：
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影响因子：
105.7
作者：
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