Integrated outpatient treatment of opioid use disorder and injection-related infections: A description of a new care model
Integrated outpatient treatment of opioid use disorder and injection-related infections: A description of a new care model
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DOI：
10.1016/j.ypmed.2019.105760
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发表时间：
2019-11-01
影响因子：
5.1
通讯作者：
Lofwall, Michelle R.
中科院分区：
文献类型：
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作者：
Fanucchi, Laura C.;Walsh, Sharon L.;Lofwall, Michelle R.
因严重注射相关感染（SIRI）住院的阿片类药物使用障碍（OUD）患者经常在IV抗生素治疗期间住院，原因是担心其是否符合门诊胃肠外抗菌治疗（OPAT）的条件，OPAT是未使用药物的患者延长IV抗生素疗程的标准治疗。作为试点研究的一部分，开发了一种新型的综合护理模式，其中OUD和SIRI患者在住院期间接受成瘾咨询和丁丙诺啡诱导，然后在门诊诊所进行持续管理，将基于办公室的阿片类药物治疗与丁丙诺啡药物治疗和OPAT咨询服务相结合。通过三个说明性的案例小插曲，门诊模式描述沿着的挑战，经验教训和未来的方向。
Persons with opioid use disorder (OUD) hospitalized with severe, injection-related infections (SIRI) are frequently hospitalized for the duration of IV antibiotic treatment due to concerns regarding their eligibility for outpatient parenteral antimicrobial therapy (OPAT), which is the standard of care for prolonged IV antibiotic courses for patients without drug use. As part of a pilot study, a novel, integrated care model was developed where patients with OUD and SIRI receive addiction consultation and buprenorphine induction while hospitalized, followed by ongoing management in an outpatient clinic that combines office-based opioid treatment with buprenorphine pharmacotherapy and counseling services with OPAT. Through three illustrative case vignettes the outpatient model is described along with challenges, lessons learned and future directions.