Response to coronavirus 2019 in Veterans Health Administration facilities participating in an implementation initiative to enhance access to medication for opioid use disorder.
Response to coronavirus 2019 in Veterans Health Administration facilities participating in an implementation initiative to enhance access to medication for opioid use disorder.
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DOI：
10.1080/08897077.2020.1809609
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发表时间：
2020
期刊：
影响因子：
3.5
通讯作者：
Hagedorn HJ
中科院分区：
文献类型：
--
作者：
Gustavson AM;Gordon AJ;Kenny ME;McHenry H;Gronek J;Ackland PE;Hagedorn HJ
减缓2019冠状病毒（COVID-19）传播所需的行动已经在医疗保健服务中形成了快速的范式转变。在危机时期，继续获得和提供阿片类药物使用障碍（M-OUD）药物对挽救生命至关重要。然而，在COVID-19之前，退伍军人健康管理局（VHA）在采用M-OUD方面存在很大差异，目前尚不清楚COVID-19大流行是否加剧了这一差距。在过去的两年里，我们的团队与八家VHA设施合作，通过多组件实施干预来提高M-OUD的采用率。本评论探讨了这些供应商对COVID-19的反应，以及随后对他们在增加采用M-OUD方面的进展的影响。简而言之，监管限制的放松促进了M-OUD的加速采用，对远程保健的快速支持提供了一种机制，以增加M-OUD的访问，并重新评估围绕M-OUD的当前做法加强了采用。总体而言，在COVID-19危机期间，设施和提供者积极响应增加获得M-OUD和适当护理OUD患者的呼吁。VHA供应商在危机中的应对措施以及在增强M-OUD方面的持续进展，部分原因可能是他们在COVID-19之前参与了实施工作，建立了资源、专家支持和实践社区。我们预计，所提出的主题可推广到其他医疗保健系统，在危机期间努力为OUD患者提供护理。我们提出了未来研究和质量改进的领域，以继续为OUD患者提供高质量的救生护理。
The actions needed to mitigate the spread of the coronavirus 2019 (COVID-19) have forged rapid paradigm shifts across healthcare delivery. In a time of crisis, continued access to and delivery of medication for opioid use disorder (M-OUD) is essential to save lives. However, prior to COVID-19, large variability in M-OUD adoption existed across the Veteran Health Administration (VHA) and it is unknown whether the COVID-19 pandemic exacerbated this divide. For the past two years, our team worked with eight VHA facilities to enhance adoption of M-OUD through a multi-component implementation intervention. This commentary explores these providers’ responses to COVID-19 and the subsequent impact on their progress toward increasing adoption of M-OUD. Briefly, the loosening of regulatory restrictions fostered accelerated adoption of M-OUD, rapid support for telehealth offered a mechanism to increase M-OUD access, and reevaluation of current practices surrounding M-OUD strengthened adoption. Overall, during the COVID-19 crisis, facilities and providers responded positively to the call for increased access to M-OUD and appropriate care of patients with OUD. The VHA providers’ responses and continued progress in enhancing M-OUD amidst a crisis may, in part, be attributable to their participation in an implementation effort prior to COVID-19 that established resources, expert support, and a community of practice. We anticipate the themes presented are generalizable to other healthcare systems grappling to deliver care to patients with OUD during a crisis. We propose areas of future research and quality improvement to continue to provide access and high quality, life-saving care to patients with OUD.
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