Medications for Alcohol Use Disorder and Retention in Care in Medicaid-Enrolled Youth, 2014-2019.
Medications for Alcohol Use Disorder and Retention in Care in Medicaid-Enrolled Youth, 2014-2019.
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2014-2019 年参加医疗补助的青少年酒精使用障碍药物和保留护理。
DOI：
10.1016/j.jadohealth.2023.03.005
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Hadland,ScottE
中科院分区：
文献类型：
--
作者：
Earlywine,JoelJ;Bagley,SarahM;Rodean,Jonathan;Zima,BonnieT;Chadi,Nicholas;Leslie,DouglasL;Hadland,ScottE
目的酒精使用障碍（AUD）是一种需要及时、有效治疗的儿童发病疾病。AUD药物是国家推荐的青少年治疗的一部分。这项研究测量了接受药物和行为健康服务的AUD和随后的保留在care.MethodsThis回顾性队列研究使用索赔数据从> 470万13-22岁的公共保险青年在15个州从2014-2019。及时治疗的定义是在AUD诊断发生后30天内接受药物（纳曲酮、阿坎酸或双硫仑）和/或行为健康服务。年龄和其他特征与及时治疗的相关性采用改良泊松回归进行鉴定。护理保留（即，结果在14,194例青少年AUD患者中，10,851例（76.4%）得到及时治疗。只有2.1%的青少年接受药物治疗（单独或联合）;几乎所有（97.9%）只接受行为健康服务。年龄较大（16-17岁）和年龄较小（13-15岁）的青少年接受药物治疗的可能性分别是年龄≥ 21岁的年轻成人的0.13倍（95%置信区间[CI]，0.07-0.26）和0.24倍（95% CI，0.11-0.51）。接受药物治疗的青少年在护理中的中位保留时间为119天（四分位数范围，54-321），而仅接受行为健康服务的青少年为108天（四分位数范围，43-243）（p= .126）。年龄≥ 18岁的年轻人与年龄< 18岁的青少年相比，停止治疗的可能性是1.12倍（95%CI，1.06-1.18）。DiscussionThis study found that more than seven in 10 youth received AUD treatment but only two in 100 received medications.未来的研究应进一步描述药物的有效性，并确定低接收率是否代表使用不足。
PurposeAlcohol use disorder (AUD) is a pediatric-onset condition needing timely, effective treatment. Medications for AUD are part of nationally recommended treatments for youth. This study measured receipt of medications and behavioral health services for AUD and subsequent retention in care.MethodsThis retrospective cohort study used claims data from > 4.7 million publicly insured youth aged 13–22 years in 15 states from 2014–2019. Timely treatment was defined as receipt of medication (naltrexone, acamprosate, or disulfiram) and/or behavioral health services within 30 days of incident AUD diagnosis. Associations of age and other characteristics with timely treatment were identified using modified Poisson regression. Retention in care (i.e., no period ≥ 60 days without claims) was studied using Cox regression.ResultsAmong 14,194 youth with AUD, 10,851 (76.4%) received timely treatment. Only 2.1% of youth received medication (alone or in combination); nearly all (97.9%) received behavioral health services only. Older (aged 16–17 years) and younger adolescents (aged 13–15 years) were 0.13 (95% confidence interval [CI], 0.07–0.26) and 0.24 (95% CI, 0.11–0.51) times as likely, respectively, to receive medications than young adults aged ≥ 21 years. Median retention in care for youth receiving medications was 119 days (interquartile range, 54–321) compared with 108 days (interquartile range, 43–243) for behavioral health services alone (p= .126). Young adults aged ≥ 18 years were 1.12 (95% CI, 1.06–1.18) times as likely to discontinue treatment compared with adolescents aged < 18 years.DiscussionThis study found that more than seven in 10 youth received AUD treatment but only two in 100 received medications. Future studies should further characterize the effectiveness of medications and determine whether low rates of receipt represent underuse.
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影响因子：
6
作者：
Hasin, Deborah;Hatzenbuehler, Mark L.;Ogburn, Elizabeth
通讯作者：
Ogburn, Elizabeth
青少年物质使用障碍的药物治疗。
DOI：
10.1016/j.chc.2010.03.010
发表时间：
2010
影响因子：
2.4
作者：
D. Simkin;Severin Grenoble
通讯作者：
Severin Grenoble
影响因子：
2.7
作者：
NEUHAUS, JM;JEWELL, NP
通讯作者：
JEWELL, NP
影响因子：
19.6
作者：
McCabe, Kristin M.;Booth, Sarah L.;Holden, Rachel M.
通讯作者：
Holden, Rachel M.
DOI：
10.1089/cap.2005.15.723
发表时间：
2005-10-01
影响因子：
1.9
作者：
Deas, D;May, K;Anton, R
通讯作者：
Anton, R