Adaptation of the Tele-Harm Reduction intervention to promote initiation and retention in buprenorphine treatment among people who inject drugs: a retrospective cohort study.
Adaptation of the Tele-Harm Reduction intervention to promote initiation and retention in buprenorphine treatment among people who inject drugs: a retrospective cohort study.
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DOI：
10.1080/07853890.2023.2182908
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发表时间：
2023-12
影响因子：
4.4
通讯作者：
中科院分区：
文献类型：
--
作者：
背景资料：在大流行开始时，丁丙诺啡处方法规的放松为创造阿片类药物使用障碍（MOUD）交付和护理的新药物模式创造了机会。为了扩大和改善获得MOUD的机会，我们调整并实施了远程伤害减少（THR）干预措施;这是一种多成分、基于远程医疗和同伴驱动的干预措施，旨在促进注射吸毒者（PWID）获得注射器服务计划（SSP）的艾滋病毒抑制。本研究检查了在IDEA迈阿密SSP接受适应性THR干预的阿片类药物使用障碍PWID中丁丙诺啡的启动和保留。研究方法：对接受THR干预MOUD的参与者进行了回顾性图表审查，以检查远程医疗对丁丙诺啡保留的影响。我们的主要结果是三个月的保留，定义为连续三个月的丁丙诺啡从药房分发。结果：共有109名参与者接受了适应性THR干预。丁丙诺啡3个月的留存率为58.7%。在基线或任何随访访视时通过远程医疗服务提供者就诊（aOR = 7.53，95% CI：[2.36，23.98]）和基线访视后接受递增剂量丁丙诺啡的参与者（aOR = 8.09，95% CI：[1.83，35.87]）在3个月时的保留率更高。基线时自我报告或兴奋剂（甲基苯丙胺、苯丙胺或可卡因）检测呈阳性的参与者在3个月时丁丙诺啡保留的校正比值较低（aOR = 0.29，95% CI：[0.09，0.93]）。远程伤害减少干预措施可适用于在注射器服务计划设置中启动和保留注射丁丙诺啡的阿片类药物使用障碍的人使用远程医疗与增加三个月丁丙诺啡保留相关基线兴奋剂使用与三个月丁丙诺啡保留呈负相关结论：减少伤害设置可以动态地适应PWID的需求，以真正的去污名化方法提供关键的救生丁丙诺啡。我们的试点表明，SSP可能是一个可接受的和可行的场所提供THR，以增加摄取丁丙诺啡的PWID和促进保留在护理。
Background: At the start of the pandemic, relaxation of buprenorphine prescribing regulations created an opportunity to create new models of medications for opioid use disorder (MOUD) delivery and care. To expand and improve access to MOUD, we adapted and implemented the Tele-Harm Reduction (THR) intervention; a multicomponent, telehealth-based and peer-driven intervention to promote HIV viral suppression among people who inject drugs (PWID) accessing a syringe services program (SSP). This study examined buprenorphine initiation and retention among PWID with opioid use disorder who received the adapted THR intervention at the IDEA Miami SSP. Methods: A retrospective chart review of participants who received the THR intervention for MOUD was performed to examine the impact of telehealth on buprenorphine retention. Our primary outcome was three-month retention, defined as three consecutive months of buprenorphine dispensed from the pharmacy. Results: A total of 109 participants received the adapted THR intervention. Three-month retention rate on buprenorphine was 58.7%. Seeing a provider via telehealth at baseline or any follow up visit (aOR = 7.53, 95% CI: [2.36, 23.98]) and participants who had received an escalating dose of buprenorphine after baseline visit (aOR = 8.09, 95% CI: [1.83, 35.87]) had a higher adjusted odds of retention at three months. Participants who self-reported or tested positive for a stimulant (methamphetamine, amphetamine, or cocaine) at baseline had a lower adjusted odds of retention on buprenorphine at three months (aOR = 0.29, 95% CI: [0.09, 0.93]). The Tele-Harm Reduction intervention can be adapted for initiating and retaining people who inject drugs with opioid use disorder on buprenorphine within a syringe services program setting Using telehealth was associated with increased three-month buprenorphine retention Baseline stimulant use was negatively associated with three-month buprenorphine retention Conclusions: Harm reduction settings can adapt dynamically to the needs of PWID in provision of critical lifesaving buprenorphine in a truly destigmatising approach. Our pilot suggests that an SSP may be an acceptable and feasible venue for delivery of THR to increase uptake of buprenorphine by PWID and promote retention in care.
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影响因子：
4.2
作者：
Behrends CN;Lu X;Corry GJ;LaKosky P;Prohaska SM;Glick SN;Kapadia SN;Perlman DC;Schackman BR;Des Jarlais DC
通讯作者：
Des Jarlais DC
影响因子：
4.4
作者：
Bartholomew, Tyler S.;Tookes, Hansel E.;Feaster, Daniel J.
通讯作者：
Feaster, Daniel J.
影响因子：
3.5
作者：
Doorley SL;Ho CJ;Echeverria E;Preston C;Ngo H;Kamal A;Cunningham CO
通讯作者：
Cunningham CO
影响因子：
5.5
作者：
Chan B;Gean E;Arkhipova-Jenkins I;Gilbert J;Hilgart J;Fiordalisi C;Hubbard K;Brandt I;Stoeger E;Paynter R;Korthuis PT;Guise JM
通讯作者：
Guise JM
影响因子：
11.8
作者：
Bouza, Emilio;Kestler, Martha;Munoz, Patricia
通讯作者：
Munoz, Patricia