Integrating peer support services into primary care-based OUD treatment: Lessons from the Penn integrated model.
Integrating peer support services into primary care-based OUD treatment: Lessons from the Penn integrated model.
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DOI：
10.1016/j.hjdsi.2022.100641
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发表时间：
2022-09
影响因子：
2.5
通讯作者：
Lowenstein, Margaret
中科院分区：
文献类型：
--
作者：
Harris, Rebecca Arden;Campbell, Kristen;Calderbank, Tara;Dooley, Patrick;Aspero, Heather;Maginnis, Jessica;O'Donnell, Nicole;Coviello, Donna;French, Rachel;Bao, Yuhua;Mandell, David S.;Bogner, Hillary R.;Lowenstein, Margaret
阿片类药物使用障碍（OUD）是美国的一个重大突发公共卫生事件。2020年，270万人拥有OUD。阿片类药物使用障碍的药物是在门诊环境中治疗OUD的循证护理标准，特别是丁丙诺啡，因为它有效且毒性低。丁丙诺啡越来越多地用于初级保健，这种环境比物质使用障碍治疗中心提供更大的匿名性和便利性。然而，开始丁丙诺啡治疗的人中有三分之二在头六个月内停止。放弃治疗会增加重新使用、感染、医疗护理和相关费用增加、司法系统介入和死亡的风险。一种有希望的保留支持形式是同伴服务计划。同行联合收割机结合他们的物质使用和恢复的生活经验与正式的培训，以帮助患者从事和坚持OUD治疗。他们提供一系列的服务，包括健康教育，鼓励和同情，应对技能，恢复模式，并在克服保留的情况障碍的具体援助。然而，需要指导，以确定同行在初级保健中的作用，同行应执行的具体任务，这些任务所需的能力，培训和专业发展的需要，以及同行的业绩标准。还需要指导将同行纳入护理团队，分配和协调护理团队成员之间的责任，管理同行业务和工作流程，并促进有效的团队沟通。在这里，我们描述了一个同行支持计划在宾夕法尼亚大学卫生系统（UPHS或宾夕法尼亚医学）网络的初级保健实践。本文详细介绍了该计划的核心组成部分，价值观和活动。我们还报告了组织的挑战，未解决的问题，并在管理同行支持计划，以满足患者的需求，由一个大型的，城市的医疗系统与广泛的郊区和农村集水区的领域的经验教训。www.clinicaltrials.gov注册号：NCT04245423。
Opioid use disorder (OUD) is a major public health emergency in the United States. In 2020, 2.7 million individuals had an OUD. Medication for opioid use disorder is the evidence-based, standard of care for treating OUD in outpatient settings, especially buprenorphine because it is effective and has low toxicity. Buprenorphine is increasingly prescribed in primary care, a setting that provides greater anonymity and convenience than substance use disorder treatment centers. Yet two-thirds of people who begin buprenorphine treatment discontinue within the first six months. Treatment dropout elevates the risks of return to use, infections, higher levels of medical care and related costs, justice system involvement, and death. One promising form of retention support is peer service programs. Peers combine their lived experience of substance use and recovery with formal training to help patients engage and persist in OUD treatment. They provide a range of services, including health education, encouragement and empathy, coping skills, recovery modeling, and concrete assistance in overcoming the situational barriers to retention. However, guidance is needed to define the peer role in primary care, the specific tasks peers should perform, the competencies those tasks require, training and professional development needs, and peer performance standards. Guidance also is needed to integrate peers into the care team, allocate and coordinate responsibilities among care team members, manage peer operations and workflow, and facilitate effective team communication. Here we describe a peer support program in the University of Pennsylvania Health System (UPHS or Penn Medicine) network of primary care practices. This paper details the program’s core components, values, and activities. We also report the organizational challenges, unresolved questions, and lessons for the field in administering a peer support program to meet the needs of patients served by a large, urban medical system with an extensive suburban and rural catchment area. www.clinicaltrials.gov registration: NCT04245423.
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影响因子：
3.9
作者：
Greiner MG;Shulman M;Choo TH;Scodes J;Pavlicova M;Campbell ANC;Novo P;Fishman M;Lee JD;Rotrosen J;Nunes EV
通讯作者：
Nunes EV
DOI：
10.3122/jabfm.2018.01.170167
发表时间：
2018-01
期刊：
Journal of the American Board of Family Medicine : JABFM
影响因子：
--
作者：
Kowalski CP;McQuillan DB;Chawla N;Lyles C;Altschuler A;Uratsu CS;Bayliss EA;Heisler M;Grant RW
通讯作者：
Grant RW
DOI：
10.1007/s10880-019-09661-z
发表时间：
2020-12-01
影响因子：
2.2
作者：
Cos, Travis A.;LaPollo, Archana Bodas;Festinger, David S.
通讯作者：
Festinger, David S.
影响因子：
3.7
作者：
Lagisetty P;Klasa K;Bush C;Heisler M;Chopra V;Bohnert A
通讯作者：
Bohnert A
影响因子：
6.2
作者：
Lowenstein M;Perrone J;Xiong RA;Snider CK;O'Donnell N;Hermann D;Rosin R;Dees J;McFadden R;Khatri U;Meisel ZF;Mitra N;Delgado MK
通讯作者：
Delgado MK