Reduction in Oregon's Medication Dosing Visits After the SARS-CoV-2 Relaxation of Restrictions on Take-home Medication.
Reduction in Oregon's Medication Dosing Visits After the SARS-CoV-2 Relaxation of Restrictions on Take-home Medication.
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DOI：
10.1097/adm.0000000000000812
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发表时间：
2021-11-01
影响因子：
5.5
通讯作者：
McCarty D
中科院分区：
文献类型：
--
作者：
McIlveen JW;Hoffman K;Priest KC;Choi D;Korthuis PT;McCarty D
为了减缓 SARS-CoV-2 在阿片类药物治疗计划 (OTP) 中的传播，SAMHSA 通知州阿片类药物治疗机构，病情稳定的患者可以接受长达 27 天的带回家治疗，不稳定的患者可以接受长达 13 天的带回家治疗，而其他患者则可以接受较少的带回家治疗。一项分析评估了放宽的标准如何影响俄勒冈州 20 个公共、非营利和营利性 OTP 中的患者服药就诊次数和带回家的药物数量。 OTP 报告了联邦政策变更前后在 3 个时间点接受带回家的患者数量：SARS-CoV-2 之前（2 月或 3 月上半月）、1 次 SARS-CoV-2 后（3 月、4 月或 5 月）和 2 次 SARS-CoV-2 后（4 月、5 月或 6 月）。对接受每种数量的带回家的患者进行计数，并计算每个患者每月的就诊次数和带回家的平均值。负二项混合效应回归模型评估了每位患者平均给药次数的变化。在 SARS-CoV-2 之前的时期，OTP 每月为 7792 名患者提供服务，进行了 120,513 次药物就诊，并分发了 44,883 份带回家的剂量。每月平均患者就诊次数为 15.5 次，每位患者每月带回家 5.8 次。政策变化后，药物就诊次数下降了 33%，带回家药物增加了 97%，每位患者平均就诊次数为 10.4 次，每位患者平均带回家药物次数为 11.3 次。负二项式混合效应回归模型估计每位患者的平均就诊次数减少了 54%。政策的改变达到了预期的效果。需要更多的研究来评估与增加获得带回家的药物相关的意外后果。
To slow the spread of SARS-CoV-2 in opioid treatment programs (OTPs), SAMHSA notified State Opioid Treatment Authorities that stable patients could receive up to 27 days of take-homes, less stable patients could receive up to 13 days with fewer take-homes for other patients. An analysis assessed how the relaxed standards affected the number of patient dosing visits and the amount of take-home medications dispensed in Oregon's 20 public, nonprofit, and for-profit OTPs. OTPs reported the number of patients receiving take homes pre and post federal policy change at 3 time points: pre SARS-CoV-2 (February or first half of March), post 1 SARS-CoV-2 (March, April, or May), and post 2 SARS-CoV-2 (April, May, or June). The patients receiving each quantity of take-homes were counted and means calculated for visits and take-homes per patient per month. A negative binomial mixed-effects regression model assessed change in mean dosing visits per patient. During the pre SARS-CoV-2 period, OTPs served 7792 patients monthly with 120,513 medication visits and dispensed 44,883 take-home doses. Mean patient visits per month were 15.5 with 5.8 take-homes per patient per month. Following the policy change, medication visits declined 33% and take-home medication increased 97% with 10.4 mean visits per patient and 11.3 mean take-homes per patient. The negative binomial mixed-effects regression model estimated a 54% reduction in mean visits per patient. The policy change had the intended effect. More research is needed to assess unintended consequences associated with increased access to take-home medication.