Mobile low-threshold buprenorphine integrated with infectious disease services.
Mobile low-threshold buprenorphine integrated with infectious disease services.
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DOI：
10.1016/j.jsat.2021.108553
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发表时间：
2022-03
影响因子：
3.9
通讯作者：
Page KR
中科院分区：
文献类型：
--
作者：
Rosecrans A;Harris R;Saxton RE;Cotterell M;Zoltick M;Willman C;Blackwell I;Bell J;Hayes D;Weir B;Sherman S;Lucas GM;Greenbaum A;Page KR
2018年，巴尔的摩市卫生局推出了一个名为“现场医疗保健”的移动诊所，提供与医疗保健服务相结合的低门槛丁丙诺啡服务，以满足吸毒者的需求。除丁丙诺啡管理外，The Spot还提供丙型肝炎、性传播感染和艾滋病毒的检测和治疗，以及艾滋病毒的暴露前预防、伤口护理、疫苗接种、纳洛酮分发和病例管理。本队列分析包括the Spot移动诊所前15个月（2018年9月4日至2019年11月23日）的临床服务数据。该地点与巴尔的摩注射器服务计划在全市五个地点位于同一地点。提供了患者人口统计和提供的服务的描述性数据，以及在1个月和3个月时保留丁丙诺啡治疗的患者的百分比。逻辑回归确定了与三个月保留率相关的因素。从2018年9月4日到2019年11月23日，Spot移动诊所为569人提供了服务，其中丁丙诺啡的处方比例为73.8%，至少一种传染病的检测比例超过70%。接受丁丙诺啡处方的患者更有可能接受艾滋病毒、丙型肝炎和性传播感染的检测，并接受丙型肝炎治疗和预防服务，包括疫苗接种和纳洛酮分发。Spot对4名患者进行了艾滋病毒治疗，对12名患者进行了艾滋病毒暴露前预防。超过32%的患者患有丙型肝炎；这些患者中有19人开始治疗丙型肝炎，其中8人有治愈记录。丁丙诺啡治疗1个月保留率为56.0%，3个月保留率为26.2%。黑人或接受丙型肝炎治疗的患者更有可能在三个月时继续使用丁丙诺啡治疗。通过低门槛、以社区为基础的护理模式增加获得综合医疗服务和药物治疗的机会，可成为解决吸毒影响的有效工具。
In 2018, the Baltimore City Health Department launched a mobile clinic called Healthcare on The Spot, which offers low-threshold buprenorphine services integrated with health care services to meet the needs of people who use drugs. In addition to buprenorphine management, The Spot offers testing and treatment for hepatitis C, sexually transmitted infections, and HIV, as well as pre-exposure prophylaxis for HIV, wound care, vaccinations, naloxone distribution, and case management. This cohort analysis includes clinical service data from the first 15 months of The Spot mobile clinic, from September 4, 2018, to November 23, 2019. The Spot co-located with the Baltimore syringe services program in five locations across the city. Descriptive data are provided for patient demographics and services provided, as well as percent of patients retained in buprenorphine treatment at one and three months. Logistic regression identified factors associated with retention at three months. The Spot mobile clinic provided services to 569 individuals from September 4, 2018, to November 23, 2019, including prescribing buprenorphine to 73.8% and testing to more than 70% for at least one infectious disease. Patients receiving a prescription for buprenorphine were more likely to be tested for HIV, hepatitis C, and sexually transmitted infections, as well as receive treatment for hepatitis C and preventive services including vaccination and naloxone distribution. The Spot initiated HIV treatment for four patients and HIV pre-exposure prophylaxis for twelve patients. More than 32% of patients had hepatitis C; nineteen of these patients initiated treatment for hepatitis C with eight having a documented cure. Buprenorphine treatment retention was 56.0% at one month and 26.2% at three months. Patients who were Black or receiving treatment for hepatitis C were more likely to be retained in buprenorphine treatment at three months. Increasing access to integrated medical services and drug treatment through low-threshold, community-based models of care can be an effective tool for addressing the effects of drug use.
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影响因子：
6
作者：
Krawczyk, Noa;Mojtabai, Ramin;Saloner, Brendan
通讯作者：
Saloner, Brendan
注射药物的人的暴露前预防（PREP）护理级联：系统评价。
影响因子：
4.4
作者：
Mistler CB;Copenhaver MM;Shrestha R
通讯作者：
Shrestha R
影响因子：
39.2
作者：
Denniston MM;Jiles RB;Drobeniuc J;Klevens RM;Ward JW;McQuillan GM;Holmberg SD
通讯作者：
Holmberg SD
影响因子：
4.2
作者：
Des Jarlais, Don C.;Arasteh, K.;Tross, Susan
通讯作者：
Tross, Susan
影响因子：
11.8
作者：
Rosenthal, Elana S.;Silk, Rachel;Kattakuzhy, Sarah
通讯作者：
Kattakuzhy, Sarah