Patient experiences of COVID-19-induced changes to methadone treatment in a large community-based opioid treatment program in Baltimore.
Patient experiences of COVID-19-induced changes to methadone treatment in a large community-based opioid treatment program in Baltimore.
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DOI：
10.1016/j.josat.2022.208946
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发表时间：
2023-02
期刊：
影响因子：
--
通讯作者：
Belcher AM
中科院分区：
文献类型：
--
作者：
Abidogun TM;Cole TO;Massey E;Kleinman M;Greenblatt AD;Seitz-Brown CJ;Magidson JF;Belcher AM
在2020年3月联邦宣布COVID-19突发公共卫生事件之后，根据保持社交距离和减少聚会的建议，联邦机构发布了全面的法规变更，以促进获得治疗阿片类药物使用障碍（mod）的药物。这些变化允许新接受治疗的患者接受多天的带回家药物治疗（THM），并使用远程技术进行治疗，而这些津贴以前只适用于符合最低依从性和治疗时间标准的“稳定”患者。然而，这些变化对低收入，少数群体患者（通常是基于阿片类药物治疗计划[OTP]的成瘾护理的最大接受者）的影响并没有很好地表征。我们的目的是探索在COVID-19 OTP调节变化之前入组治疗的患者的经历，目的是了解患者对这些变化对治疗的影响的看法。本研究包括对28名患者进行半结构化定性访谈。我们采用了有目的的抽样方法，招募了在covid -19相关政策变化生效之前积极接受治疗的个体，以及几个月后仍在接受治疗的个体。为了确保多样化的观点，我们采访了在2019冠状病毒病发病后大约12-15个月，即21年3月24日至21年6月8日期间有或没有经历过美沙酮药物依从性挑战的个体。访谈采用专题分析进行转录和编码。参与者主要是男性（57%），黑人/非裔美国人（57%），平均年龄为50.1岁（SD = 9.3）。在COVID-19之前，50%的人接受了THM治疗，在大流行期间，这一比例上升到93%。COVID-19项目的变化对治疗和康复经历产生了复杂的影响。主题确定了便利性，安全性和就业是首选THM的原因。挑战包括难以管理/储存药物，经历隔离以及担心复发。此外，一些参与者报告说，远程行为健康会议感觉不那么个人化。政策制定者应考虑患者的观点，以促进更以患者为中心的美沙酮给药方法，这种方法安全、灵活，并能适应患者的各种需求。此外，应向门诊医生提供技术支持，以确保在大流行之后维持医患关系中的人际关系。
Following the March 2020 federal declaration of a COVID-19 public health emergency, in line with recommendations for social distancing and decreased congregation, federal agencies issued sweeping regulation changes to facilitate access to medications for opioid use disorder (MOUD) treatment. These changes allowed patients new to treatment to receive multiple days of take-home medications (THM) and to use remote technology for treatment encounters—allowances that previously had been reserved exclusively for “stable” patients who met minimum adherence and time-in-treatment criteria. The impact of these changes on low-income, minoritized patients (frequently the largest recipients of opioid treatment program [OTP]-based addiction care), however, is not well characterized. We aimed to explore the experiences of patients who were enrolled in treatment prior to COVID-19 OTP regulation changes, with the goal of understanding patients' perceptions of the impact of these changes on treatment. This study included semistructured, qualitative interviews with 28 patients. We used a purposeful sampling method to recruit individuals who were active in treatment just before COVID-19-related policy changes went into effect, and who were still in treatment several months later. To ensure a diverse array of perspectives, we interviewed individuals who either had or had not experienced challenges with methadone medication adherence from 3/24/21 to 6/8/21, approximately 12–15 months following the onset of COVID-19. Interviews were transcribed and coded using thematic analysis. Participants were majority male (57 %), Black/African American (57 %), with a mean age of 50.1 (SD = 9.3). Fifty percent received THM prior to COVID-19, which increased to 93 % during the pandemic. COVID-19 program changes had mixed effects on treatment and recovery experiences. Themes identified convenience, safety, and employment as reasons for preferring THM. Challenges included difficulty with managing/storing medications, experiencing isolation, and concern about relapse. Furthermore, some participants reported that telebehavioral health encounters felt less personal. Policymakers should consider patients' perspectives to foster a more patient-centered approach to methadone dosing that is safe, flexible, and accommodating to a diverse array of patients' needs. Additionally, technical support should be provided to OTPs to ensure interpersonal connections are maintained in the patient-provider relationship beyond the pandemic.
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影响因子：
3.9
作者：
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通过远程医疗对阿片类药物使用障碍治疗的药物满意：简要文献综述和开发了新评估。
影响因子：
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DOI：
10.1186/s13011-021-00395-6
发表时间：
2021-08-09
期刊：
Substance abuse treatment, prevention, and policy
影响因子：
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