The impact of COVID-19 on healthcare delivery for people who use opioids: a scoping review.
The impact of COVID-19 on healthcare delivery for people who use opioids: a scoping review.
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DOI：
10.1186/s13011-021-00395-6
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发表时间：
2021-08-09
期刊：
影响因子：
--
通讯作者：
Rising KL
中科院分区：
文献类型：
--
作者：
Alexander K;Pogorzelska-Maziarz M;Gerolamo A;Hassen N;Kelly EL;Rising KL
COVID-19 大流行扰乱了全世界的医疗保健服务，可能对阿片类药物使用者 (PWUO) 产生负面影响。对原始研究文献的范围界定回顾描述了 COVID-19 大流行对 PWUO 医疗保健服务的影响，并找出了文献中的空白。对原始研究文献的范围界定回顾绘制了有关 COVID-19 大流行对 PWUO 医疗保健服务影响的现有知识。我们利用乔安娜布里格斯研究所开发的方法进行范围审查，并使用内容分析方法来描述文献的当前状态。在 14 项纳入研究中，行政数据库 (n = 11)、横断面 (n = 1) 或定性 (n = 2) 研究证明了服务差距 (n = 7)、患者/提供者体验 (n = 3) 以及 PWUO 的患者结果 (n = 4)。 2020 年 3 月，医疗保健利用率迅速下降，到 2020 年 5 月，仅由于阿片类药物过量的原因而急剧增加。由于容量和基础设施的限制，在大流行期间新患者获得治疗的服务存在缺口。医生报告称，由于容量和基础设施的限制增加，很难转诊患者开始门诊阿片类药物治疗计划。患者还报告了对获得门诊治疗的不确定性，但丁丙诺啡的远程医疗启动增加了在家接受治疗的机会。两项研究报告了非裔美国人用药过量率的不成比例增加，大多数研究没有检查种族和性别的差异。疫情期间，非裔美国人因服药过量致死的人数增加了 60%，而非西班牙裔白人因服药过量致死的人数则有所减少。总之，这一初步证据表明，尽管早期不愿使用医疗保健系统，但在整个大流行期间，与阿片类药物过量相关的医疗保健使用有所增加。治疗 OUD 的药物服务提供保持在或高于大流行前的水平，表明远程医疗有能力满足需求。然而，PWUO 大流行前存在的种族差异正在加剧，有必要对高危人群进行有针对性的干预，以防止进一步死亡。随着疫情的发展，未来的研究必须侧重于识别和支持 PWUO 亚群，这些亚群面临负面结果和缺乏护理机会的风险更高。
The COVID-19 pandemic disrupted healthcare delivery worldwide with likely negative effects on people who use opioids (PWUO). This scoping review of the original research literature describes the impact of the COVID-19 pandemic on healthcare delivery for PWUO and identifies gaps in the literature. This scoping review of the original research literature maps the available knowledge regarding the impact of the COVID-19 pandemic on healthcare delivery for PWUO. We utilized the methodology developed by the Joanna Briggs Institute for scoping reviews, and content analyses methodology to characterize the current state of the literature. Of the 14 included studies, administrative database (n = 11), cross-sectional (n = 1) or qualitative (n = 2) studies demonstrated service gaps (n = 7), patient/provider experiences (n = 3), and patient outcomes for PWUO (n = 4). In March 2020, healthcare utilization dropped quickly, sharply increasing only for reasons of opioid overdose by May 2020. Service gaps existed in accessing treatment for new patients during the pandemic due to capacity and infrastructure limits. Physicians reported difficulty referring patients to begin an outpatient opioid treatment program due to increased restrictions in capacity and infrastructure. Patients also reported uncertainty about accessing outpatient treatment, but that telehealth initiation of buprenorphine increased access to treatment from home. Disproportionate increases in overdose rates among African Americans were reported in two studies, with differences by race and gender not examined in most studies. Fatal overdoses increased 60% in African Americans during the pandemic, while fatal overdoses in Non-Hispanic White individuals decreased. In summary, this beginning evidence demonstrates that despite early reluctance to use the healthcare system, opioid overdose-related use of healthcare increased throughout the pandemic. Service delivery for medications to treat OUD remained at or above pre-pandemic levels, indicating the ability of telehealth to meet demand. Yet, racial disparities that existed pre-pandemic for PWUO are intensifying, and targeted intervention for high-risk groups is warranted to prevent further mortality. As the pandemic progresses, future research must focus on identifying and supporting subgroups of PWUO who are at heightened risk for experiencing negative outcomes and lack of access to care.
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影响因子：
5.7
作者：
Caton L;Cheng H;Garneau HC;Fisher T;Harris-Mills B;Hurley B;Newman S;McGovern MP
通讯作者：
McGovern MP
影响因子：
8.9
作者：
Oesterle TS;Kolla B;Risma CJ;Breitinger SA;Rakocevic DB;Loukianova LL;Hall-Flavin DK;Gentry MT;Rummans TA;Chauhan M;Gold MS
通讯作者：
Gold MS
DOI：
10.1016/j.drugpo.2021.103140
发表时间：
2021-06
期刊：
The International journal on drug policy
影响因子：
--
作者：
Krawczyk N;Bunting AM;Frank D;Arshonsky J;Gu Y;Friedman SR;Bragg MA
通讯作者：
Bragg MA
影响因子：
3.5
作者：
Hagle, Holly N.;Martin, Marlene;Lum, Paula J.
通讯作者：
Lum, Paula J.
影响因子：
5.5
作者：
Collins, Alexandra B.;Beaudoin, Francesca L.;Baird, Janette
通讯作者：
Baird, Janette