Challenges and opportunities during the COVID-19 pandemic: Treating patients for substance use disorders during the perinatal period.
Challenges and opportunities during the COVID-19 pandemic: Treating patients for substance use disorders during the perinatal period.
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DOI：
10.1016/j.ypmed.2021.106742
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发表时间：
2021-11
影响因子：
5.1
通讯作者：
Heil SH
中科院分区：
文献类型：
--
作者：
Jones HE;Hairston E;Lensch AC;Marcus LK;Heil SH
2019年冠状病毒病（COVID-19）大流行加剧了阿片类药物使用障碍的流行，并加速了酒精和其他物质使用障碍。COVID-19大流行期间卫生保健服务提供的突然变化为所有物质使用障碍患者带来了挑战和机遇，包括使用虚拟或远程医疗就诊、药物获取问题以及确保在供应无法分发时获得纳洛酮。患有药物使用障碍的孕妇和产后患者面临的独特挑战包括一些证据表明，治疗阿片类药物使用障碍的药物获得机会减少，分娩方案发生变化，将分娩人员与支持隔离开来。所有物质使用障碍患者的机会包括提供积极治疗机会的虚拟平台。它们具有时间效率，消除了交通障碍，并可能减少儿童保育障碍。对于患有药物使用障碍的孕妇和产后患者，远程医疗和亲自就诊的混合模式减少了未到诊断率，并增加了给药方案的灵活性。因此，有一个独特的机会来研究不同的虚拟护理模式的成功给予各种实施策略。COVID-19大流行提供了一个前所未有的机会，可以大幅改变标准护理方法，帮助优化对包括孕妇和产后患者在内的所有患者的护理。
The coronavirus disease 2019 (COVID-19) pandemic exacerbated the opioid use disorder epidemic and accelerated alcohol and other substance use disorders. Sudden health care service delivery changes during the COVID-19 pandemic created both challenges and opportunities for all patients with substance use disorders including the use of virtual or telemedicine visits, medication access issues and ensuring access to naloxone when supplies cannot be handed out. Unique challenges for pregnant and post-partum patients with substance use disorders includes some evidence of reduced access to medication to treat opioid use disorders and changes in delivery protocols that isolate birthing people from supports. Opportunities for all patients with substance use disorders include virtual platforms presenting positive opportunities for treatment. They are time efficient, eliminate transportation barriers, and potentially reduce childcare barriers. For pregnant and post-partum patients with substance use disorders, hybrid models of telemedicine and in-person visits reduced no-show visit rates and increased flexibility in medication dosing regimens. Thus, there is a unique opportunity to study the success of different virtual care models given the variety of implemented strategies. The COVID-19 pandemic provides an unprecedented opportunity to dramatically transform standard care approaches to help optimize care for all patients, including pregnant and post-partum people.
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