Evaluation of post-discharge engagement for emergency department patients with opioid use history who received telehealth recovery coaching services.
Evaluation of post-discharge engagement for emergency department patients with opioid use history who received telehealth recovery coaching services.
复制标题
评估接受远程医疗恢复教练服务的阿片类药物使用历史急诊室患者的入院后参与度。
DOI：
10.1186/s13011-023-00523-4
复制
发表时间：
2023-02-11
影响因子：
3.3
通讯作者：
McGuire, Alan
中科院分区：
文献类型：
--
作者：
Watson, Dennis P. P.;Phalen, Peter;Medcalf, Spencer;Messmer, Sarah;McGuire, Alan
关键词：
近年来，全国各地的急诊科（ED）已经实施了同伴恢复教练（PRC）服务，以支持使用阿片类药物的患者。文献中讨论的大多数此类干预措施都遵循亲自模式，其中PRC直接在艾德床边与患者接触。然而，在急诊室使用远程医疗服务越来越受欢迎。这些服务通过安全的通信技术将PRC与艾德患者实时连接起来，但对与之相关的基于服务和临床的结果知之甚少。本研究旨在评估与成功出院后随访的阿片类药物使用史的患者相关的因素，这些患者在ED期间接受了PRC远程医疗服务。数据来自917名患者的记录，这些患者在同一卫生系统内的13个ED中的1个中一次或多次（1208次总参与）参与远程医疗PRC。多水平泊松回归模型用于评估变量预测出院后随访成功的程度，定义为艾德出院后每月PRC与患者成功交谈的次数。23%的入组患者由PRC成功完成了至少一次随访。成功随访的重要预测因素包括基线时患者的就业情况（发病率比[IRR]：2.8，CI：2.05-3.9），居住在农村地区（内部收益率：1.8，置信区间：1.04-3.2），PRC提供转介（IRR：1.7，CI：1.2-2.2）、过去365天内遇到艾德的次数（IRR：0.99，CI：0.98-0.99）和初始PRC远程医疗互动的持续时间（IRR：0.87，CI：0.85-0.88）。鉴于关系发展是中国专业的关键工具，了解与远程医疗参与相关的成功随访具有独特的重要性。结果有潜在的效用规划和实施同行远程医疗服务，在急诊室和其他地点，这是需要为中国的职业发展和同行远程医疗服务的可能扩展。
In recent years, emergency departments (EDs) across the nation have implemented peer recovery coach (PRC) services to support patients who use opioids. The majority of such interventions discussed in the literature follow an in-person modality where PRCs engage patients directly at the ED bedside. However, the use of telehealth services in EDs is becoming more popular. These services connect PRCs with ED patients in real-time via secure communications technology, and very little is known about the service- and clinical-based outcomes with which they are associated. The current study sought to assess factors associated with successful post-discharge follow-up of patients with a history of opioid use who received PRC telehealth services while in the ED. Data come from records for 917 patients who engaged with a telehealth PRC one or more times (1208 total engagements) at 1 of 13 EDs within the same health system. A multilevel Poisson regression model was used to assess the degree to which variables predicted successful post-discharge follow-up, defined as the number of times a PRC successfully spoke with the patient each month after ED discharge. At least one follow-up was successfully completed by a PRC for 23% of enrolled patients. Significant predictors of successful follow-up included patient employment at baseline (Incidence Rate Ratio [IRR]: 2.8, CI: 2.05–3.9), living in a rural area (IRR: 1.8, CI: 1.04–3.2), PRC provision of referrals (IRR: 1.7, CI: 1.2–2.2), number of ED encounters in the previous 365 days (IRR: 0.99, CI: 0.98–0.99), and duration of the initial PRC telehealth interaction (IRR: 0.87, CI: 0.85–0.88). Given that relationship development is a key tool in the PRC profession, understanding successful follow-up associated with telehealth engagement has unique importance. The results have potential utility for planning and implementing peer telehealth services in EDs and other locations, which is needed for the development of the PRC profession and the likely expansion of peer telehealth services.
登录
查看更多内容
DOI：
10.9778/cmajo.20140089
发表时间：
2015-07-01
期刊：
CMAJ open
影响因子：
--
作者：
Bawor, Monica;Dennis, Brittany B;Samaan, Zainab
通讯作者：
Samaan, Zainab
影响因子：
5.5
作者：
Collins, Alexandra B.;Beaudoin, Francesca L.;Baird, Janette
通讯作者：
Baird, Janette
影响因子：
1.1
作者：
Lian, Heng
通讯作者：
Lian, Heng
恢复阿片类药物过量团队（根）试点计划评估：社区范围内的过量后反应策略。
影响因子：
3.5
作者：
Dahlem CHG;Scalera M;Anderson G;Tasker M;Ploutz-Snyder R;McCabe SE;Boyd CJ
通讯作者：
Boyd CJ
影响因子：
3.9
作者：
Whiteside, Lauren K.;Huynh, Ly;Morse, Sophie;Hall, Jane;Meurer, William;Banta-Green, Caleb J.;Scheuer, Hannah;Cunningham, Rebecca;McGovern, Mark;Zatzick, Douglas F.
通讯作者：
Zatzick, Douglas F.