Impact of a jail-based treatment decision-making intervention on post-release initiation of medications for opioid use disorder.
Impact of a jail-based treatment decision-making intervention on post-release initiation of medications for opioid use disorder.
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DOI：
10.1016/j.drugalcdep.2019.107799
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发表时间：
2020-02-01
影响因子：
4.2
通讯作者：
Hoeft TJ
中科院分区：
文献类型：
--
作者：
Banta-Green CJ;Williams JR;Sears JM;Floyd AS;Tsui JI;Hoeft TJ
阿片类药物使用障碍（OUD）在监狱中的人中很常见，并且可以通过药物有效治疗OUD（MOUD）。OUD患者可能对OUD和MOUD以及如何获得护理的理解不完整或不准确。我们评估了OUD治疗决策（TDM）干预，以确定干预是否增加释放后MOUD启动。我们进行了一项观察性回顾性队列研究的TDM干预开始MOUD，个人的记录数据表明确诊或怀疑OUD监禁在四个合格的监狱有资格接受干预。采用考克斯比例风险模型，以MOUD作为结局，对TDM干预进行时间-事件分析。考克斯比例风险模型，由于违反了比例假设，干预模型具有随时间变化的影响，表明接受TDM干预的人（n = 568）在出狱后的第一个月内更有可能启动MOUD（调整后的风险比6.27，95% CI）。4.20-9.37），但在随后的几个月内（AHR 1.33 95% C.I. 0.94-1.89），与未接受干预的患者（n = 3174）相比，调整人口统计学、既往MOUD或前一年的重罪或轻罪逮捕。TDM干预与开始MOUD的相对风险显著较高相关，特别是在监禁后的第一个月。然而，在所有符合条件的人中，只有少数人收到了MOUD。未来的研究应探讨如何增加启动MOUD后立即（或理想情况下在）监禁。
Opioid use disorder (OUD) is common among people in jail and is effectively treated with medications for OUD (MOUD). People with OUD may have an incomplete or inaccurate understanding of OUD and MOUD, and of how to access care. We evaluated an OUD treatment decision making (TDM) intervention to determine whether the intervention increased MOUD initiation post-release. We conducted an observational retrospective cohort study of the TDM intervention on initiation of MOUD, individuals with records data indicating confirmed or suspected OUD incarcerated in four eligible jails were eligible to receive the intervention. Time-to-event analyses of the TDM intervention were conducted using Cox proportional hazard modeling with MOUD as the outcome. Cox proportional hazard modeling, with the intervention modeled as having a time-varying effect due to violation of the proportionality assumption, indicated that those receiving the TDM intervention (n = 568) were significantly more likely to initiate MOUD during the first month after release from jail (adjusted hazard ratio 6.27, 95 % C.I. 4.20–9.37), but not in subsequent months (AHR 1.33 95 % C.I. 0.94–1.89), adjusting for demographics, prior MOUD, or felony or gross misdemeanor arrest in the prior year compared to those not receiving the intervention (n = 3174). The TDM intervention was associated with a significantly higher relative hazard of starting MOUD, specifically during the first month after incarceration. However, a minority of all eligible people received any MOUD. Future research should examine ways to increase initiation on MOUD immediately after (or ideally during) incarceration.
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影响因子：
6
作者：
Banta-Green, Caleb J.;Maynard, Charles;Donovan, Dennis M.
通讯作者：
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影响因子：
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Schwartz, Robert P.
影响因子：
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Rosenblum, Andrew
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影响因子：
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作者：
Banta-Green, Caleb J.;Floyd, Anthony S.;Tsui, Judith, I
通讯作者：
Tsui, Judith, I