Virtual opioid agonist treatment: Alberta's virtual opioid dependency program and outcomes.
Virtual opioid agonist treatment: Alberta's virtual opioid dependency program and outcomes.
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DOI：
10.1186/s13722-022-00323-4
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发表时间：
2022-07-28
影响因子：
3.7
通讯作者：
Smith, Kelly
中科院分区：
文献类型：
--
作者：
Day, Nathaniel;Wass, Maureen;Smith, Kelly
虚拟提供的医疗保健(远程保健、远程医疗)有可能缩小获得阿片类激动剂疗法(OAT)的差距。获得审查处的障碍，如缺乏交通、亲自入职要求、就业需求和有限的托儿选择，减少了客户的治疗机会。加拿大艾伯塔省已经开发出一种完全虚拟的护理模式。本文介绍了独特的虚拟诊所模型，并描述了该模型的成果。使用艾伯塔省虚拟阿片依赖方案的现有电子健康记录和数据库中的数据集进行了回溯性图表审查。结果数据是在接受持续护理时由病例管理公司在VODP内以及治疗持续3、6和12个月时提取的。分析了三年来的使用趋势，包括入院、出院和活跃客户信息。在四个时间段内汇总了参与VODP持续护理的客户的临床结果的数据以进行分析，包括6个月和12个月的治疗保留率。研究样本中共包括440条客户记录。描述性分析显示，三个财政年度的使用量快速增长。尽管使用率快速增长，但由于启动了当天启动服务，以支持低门槛立即获得治疗，治疗等待天数的中位数从6天减少到0天。持续护理中患者的治疗保留率与已发表的报告相当，90%的研究样本在治疗中保持6个月以上，58%显示保持12个月以上。客户报告的满意度很高(90%)，结果反映了药物使用和过量服药的减少以及社会功能的改善。VODP型显示出高水平的客户满意度、使用率的快速增长和积极的初步临床结果。在芬太尼过量危机的背景下，完全虚拟地提供阿片激动剂疗法是一个很有希望的选择，可以促进获得阿片使用障碍(OUD)的循证治疗，特别是对于生活在农村或服务不足地区的个人。
Virtually delivered healthcare (telehealth, telemedicine) has the potential to reduce gaps in access to opioid agonist therapy (OAT). Barriers to accessing OAT such as lack of transportation, in-person induction requirements, employment demands and limited childcare options reduce treatment opportunities for clients. A completely virtual model of care has been developed in Alberta, Canada. This paper introduces the unique virtual clinic model and describes outcomes from that model. A retrospective chart review was conducted using datasets within existing electronic health records and databases from Alberta’s Virtual Opioid Dependency Program (VODP). Outcome data were extracted at admission to ongoing care by Case Management within the VODP and at 3, 6 and 12 months for the duration of treatment. Utilization trends over three years were analyzed, including admissions, discharges and active client information. Data regarding clinical outcomes for clients engaged in ongoing care with the VODP were aggregated for analysis over four time periods, including treatment retention rates at 6 and 12 months. A total of 440 client records were included in the study sample. Descriptive analysis showed rapid growth in utilization over three fiscal years. Despite rapid growth in utilization, median wait days for treatment decreased from 6 to 0 days with the initiation of a Same Day Start service to support low barrier immediate access to treatment. Treatment retention rates for clients in ongoing care were comparable to published reports, with 90% of the study sample remaining in treatment over 6 months, and 58% showing retention over 12 months. Clients reported high levels of satisfaction (90%) and outcomes reflected reductions in drug use and overdose as well as improved social functioning. The VODP model demonstrated high levels of client satisfaction, rapid growth in utilization and positive preliminary clinical outcomes. Entirely virtual delivery of opioid agonist therapy is a promising option to facilitate access to evidence based treatment for opioid use disorder (OUD) in the context of a fentanyl overdose crisis, particularly for individuals living in rural or underserved areas.
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影响因子：
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作者：
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通讯作者：
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作者：
Eibl, Joseph K.;Gauthier, Graham;Marsh, David C.
通讯作者：
Marsh, David C.
DOI：
10.1007/s11414-018-9611-1
发表时间：
2019-10-01
影响因子：
1.9
作者：
Mahmoud, Hossam;Vogt, Emily
通讯作者：
Vogt, Emily
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作者：
McIntyre, Jessica L.
通讯作者：
McIntyre, Jessica L.