Opioid Use Disorder Treatment Initiation and Continuation: a Qualitative Study of Patients Who Received Addiction Consultation and Hospital-Based Providers.
Opioid Use Disorder Treatment Initiation and Continuation: a Qualitative Study of Patients Who Received Addiction Consultation and Hospital-Based Providers.
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DOI：
10.1007/s11606-021-07305-3
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发表时间：
2022-08
影响因子：
5.7
通讯作者：
Binswanger IA
中科院分区：
文献类型：
--
作者：
Calcaterra SL;Lockhart S;Callister C;Hoover K;Binswanger IA
与阿片类药物使用障碍(OUD)相关的住院人数正在上升。成瘾咨询服务(ACS)越来越多地为住院患者提供OUD治疗，但OUD开始和继续用药的障碍仍然存在。在急性冠脉综合征的背景下，我们从患者和医护人员的角度考察了以医院为基础的OUD治疗启动和继续的促进者和障碍。在这项定性研究中，我们通过关键的信息者访谈和焦点小组从住院期间接受ACS护理的患者以及在医院工作的住院医生、药剂师、社会工作者和护士寻求意见。一个多学科团队使用定向内容分析对成绩单进行编码和分析。我们对患者进行了20次关键的线人访谈，其中9人在出院后接受了采访，12人在再次住院期间接受了采访。我们完成了6个焦点小组和8个关键线人对住院医生和医院医务人员的访谈(n=62)。与以医院为基础的OUD治疗相关的紧急主题包括：促进OUD治疗接触的急性冠脉综合征的益处；扩大使用美沙酮或丁丙诺啡治疗阿片类药物戒断；住院、自我效能和易于获得的以患者为中心的治疗三者结合促使改变阿片类药物的使用；适当的疼痛控制和稳定OUD患者的心理健康状况有助于阿片类药物激动剂治疗(OAT)的继续；稳定的住房和社会支持是OAT吸收和持续的先决条件。促进以医院为基础的OUD治疗开始和继续的可修改因素包括可获得院内成瘾专业知识以提供易于获得的、以患者为中心的治疗，以及使用美沙酮或丁丙诺啡管理阿片类药物的戒断。迫切需要进一步的研究和公共政策努力，以消除在医院开展和继续治疗的障碍，这些障碍包括住房不稳定、慢性医疗和精神疾病控制不善以及缺乏社会支持。网上版载有补充材料，可在10.1007/s11606-021-07305-3查阅。
Hospitalizations related to opioid use disorder (OUD) are rising. Addiction consultation services (ACS) increasingly provide OUD treatment to hospitalized patients, but barriers to initiating and continuing medications for OUD remain. We examined facilitators and barriers to hospital-based OUD treatment initiation and continuation from the perspective of patients and healthcare workers in the context of an ACS. In this qualitative study, we sought input using key informant interviews and focus groups from patients who received care from an ACS during their hospitalization and from hospitalists, pharmacists, social workers, and nurses who work in the hospital setting. A multidisciplinary team coded and analyzed transcripts using a directed content analysis. We conducted 20 key informant interviews with patients, nine of whom were interviewed following hospital discharge and 12 of whom were interviewed during a rehospitalization. We completed six focus groups and eight key informant interviews with hospitalists and hospital-based medical staff (n = 62). Emergent themes related to hospital-based OUD treatment included the following: the benefit of an ACS to facilitate OUD treatment engagement; expanded use of methadone or buprenorphine to treat opioid withdrawal; the triad of hospitalization, self-efficacy, and easily accessible, patient-centered treatment motivates change in opioid use; adequate pain control and stabilization of mental health conditions among patients with OUD contributed to opioid agonist therapy (OAT) continuation; and stable housing and social support are prerequisites for OAT uptake and continuation. Modifiable factors which facilitate hospital-based OUD treatment initiation and continuation include availability of in-hospital addiction expertise to offer easily accessible, patient-centered treatment and the use of methadone or buprenorphine to manage opioid withdrawal. Further research and public policy efforts are urgently needed to address reported barriers to hospital-based OUD treatment initiation and continuation which include unstable housing, poorly controlled chronic medical and mental illness, and lack of social support. The online version contains supplementary material available at 10.1007/s11606-021-07305-3.
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影响因子：
3.2
作者：
Hsieh, HF;Shannon, SE
通讯作者：
Shannon, SE
DOI：
10.1111/add.15383
发表时间：
2021-07
期刊：
Addiction (Abingdon, England)
影响因子：
--
作者：
Braithwaite V;Ti L;Fairbairn N;Ahamad K;McLean M;Harrison S;Wood E;Nolan S
通讯作者：
Nolan S
影响因子：
4.2
作者：
Hyshka, Elaine;Morris, Heather;Salvalaggio, Ginetta
通讯作者：
Salvalaggio, Ginetta
影响因子：
6
作者：
Caldeiro, Ryan M.;Malte, Carol A.;Saxon, Andrew J.
通讯作者：
Saxon, Andrew J.
影响因子：
3.8
作者：
Elo, Satu;Kyngaes, Helvi
通讯作者：
Kyngaes, Helvi