The Transitions Clinic Network: Post Incarceration Addiction Treatment, Healthcare, and Social Support (TCN-PATHS): A hybrid type-1 effectiveness trial of enhanced primary care to improve opioid use disorder treatment outcomes following release from jail.
The Transitions Clinic Network: Post Incarceration Addiction Treatment, Healthcare, and Social Support (TCN-PATHS): A hybrid type-1 effectiveness trial of enhanced primary care to improve opioid use disorder treatment outcomes following release from jail.
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DOI：
10.1016/j.jsat.2021.108315
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发表时间：
2021-09
影响因子：
3.9
通讯作者：
Wang EA
中科院分区：
文献类型：
--
作者：
Howell BA;Puglisi L;Clark K;Albizu-Garcia C;Ashkin E;Booth T;Brinkley-Rubinstein L;Fiellin DA;Fox AD;Maurer KF;Lin HJ;McCollister K;Murphy S;Morse DS;Shavit S;Wang K;Winkelman T;Wang EA
2016年，至少有20%的阿片类药物使用障碍（OUD）患者涉及刑事司法系统，其中大多数人在监狱中骑车。阿片类药物过量是死亡的主要原因，也是出狱后发病的常见原因。治疗OUD（MOUD）的药物可以有效减少药物过量，但很少有干预措施能成功地吸引和留住从监禁中释放出来的人。评估过渡诊所网络（TCN）的后续护理是否为从监禁中释放的人提供OUD治疗和增强的初级护理，改善了出狱后阿片类药物治疗级联的关键措施。在TCN方案中，初级保健小组包括一名有监禁史的社区卫生工作者，负责满足住房、粮食不安全和刑事法律的系统联系等社会需求，并沿着患者的医疗需求。我们将把六个惩教系统和社区卫生中心与TCN计划结合起来，在MOUD上从监狱释放的个人中进行混合型1有效性/实施研究。我们将对来自7个当地监狱（布里奇波特，CT; Niantic，CT;布朗克斯，NY;卡瓜斯，PR;达勒姆，NC;明尼阿波利斯，MN;安大略县，NY）的800名MOUD释放个体进行随机化，以比较TCN干预与转诊至标准初级保健的有效性，以改善阿片类药物治疗级联中的措施。我们还将确定哪些健康的社会决定因素正在介导分配到TCN计划和阿片类药物治疗级联措施之间的任何观察到的关联。最后，我们将研究这种方法的成本效益，以及个人，组织和政策层面的障碍和促进因素，以成功地将MOUD上的个人护理从监狱过渡到TCN。北卡罗来纳州大学调查审查委员会（IRB研究编号19-1713）、人类研究保护办公室和NIDA JCOIN数据安全监测委员会批准了该研究。我们将通过同行评审的出版物和学术和社区演示来传播研究结果。我们将通过一个基于网络的平台发布研究数据，与TCN PATHS参与者和其他TCN利益相关者共享数据。Clinicaltrials.gov注册号：NCT 04309565。
In 2016, at least 20% of people with opioid use disorder (OUD) were involved in the criminal justice system, with the majority of individuals cycling through jails. Opioid overdose is the leading cause of death and a common cause of morbidity after release from incarceration. Medications for OUD (MOUD) are effective at reducing overdoses, but few interventions have successfully engaged and retained individuals after release from incarceration in treatment. To assess whether follow-up care in the Transitions Clinic Network (TCN), which provides OUD treatment and enhanced primary care for people released from incarceration, improves key measures in the opioid treatment cascade after release from jail. In TCN programs, primary care teams include a community health worker with a history of incarceration, which attend to social needs such as housing, food insecurity and criminal legal system contact, along with patients’ medical needs. We will bring together six correctional systems and community health centers with TCN programs to conduct a hybrid type 1 effectiveness/implementation study among individuals who were released from jail on MOUD. We will randomize 800 individuals on MOUD released from seven local jails (Bridgeport, CT; Niantic, CT; Bronx, NY; Caguas, PR; Durham, NC; Minneapolis, MN; Ontario County, NY) to compare the effectiveness of a TCN intervention versus referral to standard primary care to improve measures within the opioid treatment cascade. We will also determine what social determinants of health are mediating any observed associations between assignment to the TCN program and opioid treatment cascade measures. Lastly, we will study the cost effectiveness of the approach, as well as individual, organizational, and policy level barriers and facilitators to successfully transitioning the care of individuals on MOUD from jail to the TCN. Investigation Review Board the University of North Carolina (IRB Study # 19-1713), the Office of Human Research Protections, and the NIDA JCOIN Data Safety Monitoring Board approved the study. We will disseminate study findings through peer-reviewed publications and academic and community presentations. We will disseminate study data through a web-based platform design to share data with TCN PATHS participants and other TCN stakeholders. Clinicaltrials.gov registration: NCT04309565.
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3.9
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