An analysis of initial service transformation in response to the COVID-19 pandemic in two inner-city substance misuse services
An analysis of initial service transformation in response to the COVID-19 pandemic in two inner-city substance misuse services
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DOI：
10.1080/14659891.2020.1820089
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发表时间：
2020-09-28
影响因子：
0.8
通讯作者：
Grewal, Pardeep
中科院分区：
文献类型：
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作者：
Hazan, Jemma;Congdon, Lawrence;Grewal, Pardeep
背景COVID-19疫情对物质滥用服务提出了挑战。患者面临更高的感染和传播给他人的风险。服务需要迅速重新配置，以应对政府封锁。这些修改必须在国家指南公布之前完成。方法研究两个伦敦行政区的战略和业务交付，并衡量它们与国家指导方针的趋同程度。对转诊数据进行了分析，并与COVID-19前的类似时间框架进行了比较。结果两个部门都采取了类似的战略和改革步伐。鸦片替代疗法的供应时间较长，对收集的限制较少。阿片类药物评估有所增加，酒精评估有所减少。死亡率总体上没有增加。在最初公布时，与国家指导略有偏差。结论：各部门装备精良，能够应对早期封锁期间所需的快速变化。OST中限制的减少可能与负面服务或患者结局无关。远程咨询和在家工作的转变可能会对大流行后的药物滥用服务产生价值。封锁的长期影响在临床安全性方面存在不确定性，需要进行评价。
Background The COVID-19 pandemic presents challenges to substance misuse services. Patients face a higher risk of infection and transmission to others. Services were required to reconfigure quickly in response to the government lockdown. These changes had to be completed before national guidance was published. Method To examine the strategy and operational delivery of two London boroughs and measure how convergent they were with national guidelines. Referral data were analyzed and compared to a similar time frame pre-COVID-19. Results Both services adopted similar strategies and pace of change. Longer supplies of opiate substitution therapy (OST) were prescribed, with less restrictive arrangements for collection. There was an increase in opiate assessments and a reduction in alcohol assessments. There was no overall increase in mortality. There was minor deviation from national guidance when it was initially published. Conclusions The services were well equipped to respond to the rapid changes demanded during early lockdown. Reduced restrictions in OST may not be associated with negative service or patient outcomes. The move to remote consultations and home working are likely to have value in substance misuse services after the pandemic. The long-term impact of lockdown presents uncertainties in terms of clinical safety and requires evaluation.