Access to treatment for pregnant incarcerated people with opioid use disorder: Perspectives from community opioid treatment providers.
Access to treatment for pregnant incarcerated people with opioid use disorder: Perspectives from community opioid treatment providers.
复制标题
获得阿片类药物使用障碍的孕妇监禁患者的治疗方法：社区阿片类药物治疗提供者的观点。
DOI：
10.1016/j.jsat.2021.108338
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发表时间：
2021-07
影响因子：
3.9
通讯作者：
Sufrin C
中科院分区：
文献类型：
--
作者：
King Z;Kramer C;Latkin C;Sufrin C
许多监狱设施为患有阿片使用障碍(OUD)的孕妇提供有限的阿片使用障碍(Moud)药物，尽管这是护理的标准。我们旨在探讨阿片类药物治疗提供者(OTP)在监禁期间和监禁后孕妇获得MOD的前景。我们对供应商和管理人员进行了16次半结构化电话采访，代表了美国多个阿片类药物母亲使用率较高的州的16个独特的OTP。我们使用实施研究综合框架开发了访谈指南，并使用直接内容分析对访谈记录进行了分析。9名参与者报告说，他们与一家监禁机构达成了一项安排，为患有OUD的孕妇提供护理；然而，其他人描述了他们当地的监狱如何没有为被监禁的孕妇提供OUD治疗。即使参与者的诊所有在监狱中提供Moud的安排，大多数参与者将监狱和社区提供者之间持续护理的重大障碍描述为患者在监狱和社区环境之间的过渡。OTPS描述了他们的信念，即监禁后，孕妇如何经历OUD护理的障碍，如无法获得儿童护理、为婴儿做准备、感觉不适，以及非孕妇经历的障碍，如交通、住房和资金。OTPS认为，由于歧视、护理的连续性困难以及在监禁期间缺乏治疗机会，患有OUD的孕妇在被监禁期间和在社区环境中在获得治疗方面遇到了严重障碍。对监狱中的孕妇实施循证穆德治疗，并在获释后继续治疗，对于减少健康差距至关重要。
Many jail facilities provide limited access to medications for opioid use disorder (MOUD) for pregnant people with opioid use disorder (OUD), despite it being the standard of care. We aim to explore the perspectives of opioid treatment providers (OTPs) on access to MOUD for pregnant people while incarcerated and postincarceration. We conducted 16 semistructured phone interviews with providers and administrators representing 16 unique OTPs in various U.S. states with high maternal opioid use rates. We developed the interview guide using the Consolidated Framework for Implementation Research, and we analyzed interview transcripts using a direct content analysis. Nine participants reported having an arrangement with a carceral facility to provide care for pregnant people with OUD; however, others described how their local jail offered no OUD treatment for incarcerated pregnant people. Even if participants’ clinics had arrangements to provide MOUD in a jail, most participants described significant barriers to continuity of care between jails and community providers as patients transition between jails and community settings. OTPs described their belief of how postincarceration, pregnant people experience barriers to OUD care such as lack of access to childcare, preparing for the baby, feeling unwell, in addition to the barriers that nonpregnant patients experience, such as transportation, housing, and financing. OTPs perceive that pregnant people with OUD experience significant barriers to accessing treatment while incarcerated and in community settings due to discrimination, difficulties in continuity of care, and lack of treatment access while incarcerated. The implementation of evidence-based MOUD treatment for pregnant people in jail and continuation of treatment upon release is crucial to reduce health disparities.
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影响因子：
3.2
作者：
Hsieh, HF;Shannon, SE
通讯作者：
Shannon, SE
影响因子：
2.3
作者：
Kelsey, C. M.;Medel, Nickole;Forestell, Catherine
通讯作者：
Forestell, Catherine
影响因子：
3.2
作者：
Kozhimannil, Katy B.;Graves, Amy J.;Patrick, Stephen W.
通讯作者：
Patrick, Stephen W.
影响因子：
2.9
作者：
Patrick, S. W.;Davis, M. M.;Cooper, W. O.
通讯作者：
Cooper, W. O.
影响因子：
7.2
作者：
Krans, Elizabeth E.;Patrick, Stephen W.
通讯作者：
Patrick, Stephen W.