National Survey in Medical and Surgical Decision-Making for Recurrent Injection Drug Use-Related Infective Endocarditis.
National Survey in Medical and Surgical Decision-Making for Recurrent Injection Drug Use-Related Infective Endocarditis.
复制标题
反复注射吸毒相关感染性心内膜炎的医疗和外科决策全国调查。
DOI：
10.1016/j.jaclp.2022.08.008
复制
发表时间：
2023
影响因子：
2.3
通讯作者：
Lowenstein,Margaret
中科院分区：
文献类型：
--
作者：
Zwiebel,Samantha;Meisner,Jessica;Lowenstein,Margaret
与注射毒品使用相关的感染性心内膜炎(IDU-IE)和相关手术急剧增加，1精神病学经常会诊以解决潜在的物质使用障碍。外科指南指出，对于注射毒品的人，应根据标准适应症进行IE相关手术，治疗应包括成瘾管理2，尽管IDU-IE的管理仍存在争议。虽然对潜在使用障碍的评估和治疗是管理IDU-IE的关键，但精神病学在IDU-IE患者临床决策中的整个作用尚不清楚。这项研究的目的是描述美国学术医学中心复发的IDU-IE患者的临床决策。我们使用研究电子数据捕获(RedCap)安全在线平台，于2021年3月至9月对学术医学中心的传染病医生进行了横断面调查。我们调查了受访者是否知道任何制度政策或典型的决策做法。问题还集中在可用的医院资源、团队参与决策、影响心理社会因素以及阿片类药物使用障碍(MOUD)的药物使用。问题是多项选择和可选的自由文本输入。为了描述我们的样本，我们从Vizient临床数据库中提取了2020财年的医院级别数据(德克萨斯州欧文；经Vizient，Inc.许可使用，保留所有权利)。
Injection drug use-related infective endocarditis (IDU-IE) and associated surgeries have increased dramatically, 1 with psychiatry often consulted to address an underlying substance use disorder. Surgical guidelines state that IE-related surgery should be performed for standard indications in people who inject drugs, and treatment should include management of addiction2 although management of IDU-IE remains controversial. While assessment and treatment of the underlying use disorder are key to managing IDU-IE, the whole role of psychiatry in clinical decision-making for patients with IDU-IE is unclear. The aim of the study was to describe clinical decision-making for patients with recurrent IDU-IE at US academic medical centers.We conducted a cross-sectional survey of infectious disease physicians from academic medical centers between March and September 2021 using the Research Electronic Data Capture (REDCap) secure online platform. We investigated if a respondent was aware of any institutional policies or typical decision-making practices. Questions also focused on available hospital resources, team engagement in decision-making, influential psychosocial factors, and utilization of medications for opioid use disorder (MOUD). Questions were multiple-choice with optional free-text entry. To describe our sample, we extracted hospitallevel data from the Vizient Clinical Data Base for fiscal year 2020 (Irving, TX; used with permission of Vizient, Inc, all rights reserved).