Pharmacy-based methadone dispensing and drive time to methadone treatment in five states within the United States: A cross-sectional study.
Pharmacy-based methadone dispensing and drive time to methadone treatment in five states within the United States: A cross-sectional study.
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DOI：
10.1016/j.drugalcdep.2020.107968
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发表时间：
2020-03-27
影响因子：
4.2
通讯作者：
Calcaterra SL
中科院分区：
文献类型：
--
作者：
Joudrey PJ;Chadi N;Roy P;Morford KL;Bach P;Kimmel S;Wang EA;Calcaterra SL
在美国，阿片类药物治疗计划（OTP）短缺，这些设施为阿片类药物使用障碍提供美沙酮。目前尚不清楚国际上现有的基于药房的美沙酮配药如何影响美沙酮的获得。我们的目的是比较开车到最近的OTP的时间与开车到最近的连锁药店在城市和农村人口普查区。2018年OTP位置数据和2017年药房位置数据的横截面地理空间分析。我们纳入了印第安纳州、肯塔基州、俄亥俄州、弗吉尼亚州和西弗吉尼亚州的非零人口普查区，这些州的阿片类药物过量死亡率最高。我们的结果是从人口普查区平均人口中心到最近的配药设施的最短驾驶时间（分钟）。在7，918个人口普查区中，从城市到越来越多的农村人口普查区分类，到OTP的中位数（IQR）驾驶时间增加[16.1分钟（10.2 - 25.9）到48.4分钟（34.0 - 63.3）; p <.001]。在所有人口普查区中，到OTP的平均（IQR）驾驶时间大于到连锁药店的驾驶时间：分别为19.6分钟（11.6 - 35.1）和4.4分钟（2.9 - 7.7）; p <0.001。在越来越多的农村人口普查区，驾驶时间的中位数（IQR）差异更大[11.5分钟（6.1 - 19.2）至35.2分钟（19.6 - 49.7）; p <.001]，以药房为基础的美沙酮分发。农村人口普查区到OTP的车程时间过长。借鉴加拿大和澳大利亚等国家增加美沙酮获取的政策，可以通过实施基于药店的美沙酮分发来缓解美沙酮的地理差异。
Within the United States, there is a shortage of opioid treatment programs (OTPs), facilities which dispense methadone for opioid use disorder. It is unknown how pharmacy-based methadone dispensing, as available internationally, could affect methadone access. We aimed to compare drive times to the nearest OTP with drive times to the nearest chain pharmacy in urban and rural census tracts. Cross-sectional geospatial analysis of 2018 OTP location data and 2017 pharmacy location data. We included census tracts with non-zero population in Indiana, Kentucky, Ohio, Virginia, and West Virginia, states with highest rates of opioid overdose deaths. Our outcome was minimum drive time in minutes from census tract mean center of population to the nearest dispensing facility. Among 7,918 census tracts, median (IQR) drive time to OTPs increased from urban to increasingly rural census tract classification [16.1 minutes (10.2 – 25.9) to 48.4 minutes (34.0 – 63.3); p <.001]. Median (IQR) drive time to OTPs was greater than drive time to chain pharmacies among all census tracts: 19.6 minutes (11.6 – 35.1) versus 4.4 minutes (2.9 – 7.7) respectively; p <.001. The median (IQR) difference in drive time was greater for increasingly rural census tracts [11.5 minutes (6.1 – 19.2) to 35.2 minutes (19.6 – 49.7); p <.001] with pharmacy-based methadone dispensing. Rural census tracts have disproportionately long drive times to OTPs. Drawing from policies to increase methadone access in countries like Canada and Australia, this geographic methadone disparity could be mitigated through implementation of pharmacy-based methadone dispensing.
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影响因子：
5.5
作者：
Besser, Lilah M.;Marcus, Michele;Frumkin, Howard
通讯作者：
Frumkin, Howard
影响因子：
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作者：
Calcaterra, S. L.;Bach, P.;Samet, J. H.
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Samet, J. H.
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作者：
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通讯作者：
Amram, Ofer
影响因子：
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作者：
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通讯作者：
Reisinger, Heather Schacht
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3.5
作者：
Bakhireva, Ludmila N.;Bautista, Adriana;Cruz, Theresa H.
通讯作者：
Cruz, Theresa H.