Office-Based Opioid Treatment with Buprenorphine (OBOT-B): State-wide Implementation of the Massachusetts Collaborative Care Model in Community Health Centers
Office-Based Opioid Treatment with Buprenorphine (OBOT-B): State-wide Implementation of the Massachusetts Collaborative Care Model in Community Health Centers
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DOI：
10.1016/j.jsat.2015.06.010
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发表时间：
2016-01-01
影响因子：
3.9
通讯作者：
Samet, Jeffrey H.
中科院分区：
文献类型：
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作者：
LaBelle, Colleen T.;Han, Steve Choongheon;Samet, Jeffrey H.
我们描述了马萨诸塞州药物滥用服务局（BSAS）的倡议，该倡议旨在传播基于办公室的丁丙诺啡阿片类药物治疗（OBOT-B）马萨诸塞州模式，从波士顿医疗中心（BMC）的发展到2007年开始在14个社区卫生中心（CHCs）实施。马萨诸塞州合作护理模式提供阿片类药物激动剂丁丙诺啡治疗，其中护士与医生在患者的评估和监测中发挥核心作用，有望有效扩大阿片类药物使用障碍的治疗。介绍了OBOT护士的培训和技术援助以及有限的项目评估。跨越6年（2007-2013）的数据报告了患者人口统计、阿片类药物使用障碍的既往治疗、过量用药史、住房和就业情况。将OBOT扩展到14个CHCs后，“豁免”（即允许他们开丁丙诺啡处方）的医生数量在3年内增加了375%，从24人增加到114人。在此期间，每年因CHCs就诊的OBOT患者显著增加。传播基于办公室的丁丙诺啡阿片类药物治疗马萨诸塞州模式，采用协作护理模式，以护理为核心角色，在整个马萨诸塞州的社区卫生中心对阿片类药物使用障碍患者实施有效治疗，同时有效地吸引初级保健医生参与这项工作。(C) 2015爱思唯尔公司版权所有。
We describe a Massachusetts Bureau of Substance Abuse Services' (BSAS) initiative to disseminate the office-based opioid treatment with buprenorphine (OBOT-B) Massachusetts Model from its development at Boston Medical Center (BMC) to its implementation at fourteen community health centers (CHCs) beginning in 2007. The Massachusetts Collaborative Care Model for the delivery of opioid agonist therapy with buprenorphine, in which nurses working with physicians play a central role in the evaluation and monitoring of patients, holds promise for the effective expansion of treatment for opioid use disorders. The training of and technical assistance for the OBOT nurses as well as a limited program assessment are described. Data spanning 6 years (2007-2013) report patient demographics, prior treatment for opioid use disorders, history of overdose, housing, and employment. The expansion of OBOT to the fourteen CHCs increased the number of physicians who were "waivered" (i.e., enabling their prescribing of buprenorphine) by 375%, from 24 to 114, within 3 years. During this period the annual admissions of OBOT patients to CHCs markedly increased. Dissemination of the Massachusetts Model of the Office-Based Opioid Treatment with Buprenorphine employing a collaborative care model with a central role for nursing enabled implementation of effective treatment for patients with an opioid use disorder at community health centers throughout Massachusetts while effectively engaging primary care physicians in this endeavor. (C) 2015 Elsevier Inc. All rights reserved.