Opioid use disorder Cascade of care framework design: A roadmap.
Opioid use disorder Cascade of care framework design: A roadmap.
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DOI：
10.1080/08897077.2022.2074604
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发表时间：
2022
期刊：
影响因子：
3.5
通讯作者：
Olfson, Mark
中科院分区：
文献类型：
--
作者：
Williams, Arthur Robin;Johnson, Kimberly A.;Thomas, Cindy Parks;Reif, Sharon;Socias, Eugenia M.;Henry, Brandy F.;Neighbors, Charles;Gordon, Adam J.;Horgan, Constance;Nosyk, Bohdan;Drexler, Karen;Krawczyk, Noa;Gonsalves, Gregg S.;Hadland, Scott E.;Stein, Bradley D.;Fishman, Marc;Kelley, A. Taylor;Pincus, Harold A.;Olfson, Mark
非故意的过量用药死亡（大多数涉及阿片类药物）已经超过了美国50岁以下人群的所有其他死亡原因。据估计，有240万到500万人患有阿片类药物使用障碍（OUD），然而在某一年只有少数人接受治疗。治疗OUD的药物（MOUD）是OUD的黄金标准治疗方法，然而早期停药仍然是改善临床结果的一个主要挑战。护理级联（CoC）框架最初作为一种遏制艾滋病传播的公共卫生责任策略而普及，现已专门针对OUD进行了调整。美国国立卫生研究院（NIH）以及几个州和辖区推广了CoC框架，通过临床、政策和行政手段来组织质量改进工作，以提高OUD治疗的启动和维持率。本路线图根据现有数据和潜在联系详细阐述了CoC设计领域，因为各个州机构和卫生系统通常依赖有限的数据集，这些数据集受到不同的法律和监管要求的约束，限制了评估的选择。提供了图形决策树和分类研究，以帮助指导州机构和卫生系统在OUD CoC框架下改进数据收集和监测工作。
Unintentional overdose deaths, most involving opioids, have eclipsed all other causes of US deaths for individuals less than 50 years of age. An estimated 2.4 to 5 million individuals have opioid use disorder (OUD) yet a minority receive treatment in a given year. Medications for OUD (MOUD) are the gold standard treatment for OUD however early dropout remains a major challenge for improving clinical outcomes. A Cascade of Care (CoC) framework, first popularized as a public health accountability strategy to stem the spread of HIV, has been adapted specifically for OUD. The CoC framework has been promoted by the NIH and several states and jurisdictions for organizing quality improvement efforts through clinical, policy, and administrative levers to improve OUD treatment initiation and retention. This roadmap details CoC design domains based on available data and potential linkages as individual state agencies and health systems typically rely on limited datasets subject to diverse legal and regulatory requirements constraining options for evaluations. Both graphical decision trees and catalogued studies are provided to help guide efforts by state agencies and health systems to improve data collection and monitoring efforts under the OUD CoC framework.
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