Implementation of the hub and spoke model for opioid use disorders in California: Rationale, design and anticipated impact
Implementation of the hub and spoke model for opioid use disorders in California: Rationale, design and anticipated impact
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DOI：
10.1016/j.jsat.2019.07.013
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发表时间：
2020-01-01
影响因子：
3.9
通讯作者：
Rawson, Richard
中科院分区：
文献类型：
--
作者：
Miele, Gloria M.;Caton, Lauren;Rawson, Richard
作为国家有针对性地应对阿片类药物流行的一部分，加利福尼亚州采用了中心辐射模式，在全州扩大获得治疗阿片类药物使用障碍的药物，特别是丁丙诺啡。通过将阿片类药物治疗计划作为枢纽，以初级保健、办公室从业人员和其他医疗保健机构为发言人，更广泛的治疗模式可以覆盖更多的阿片类药物使用障碍患者，改善阿片类药物使用障碍的药物获得，并减少过量死亡。扩大准入需要扩大知识，并深入实施新的做法。本文描述了加州中心辐射系统实施计划的理由、具体活动和预期影响。培训和技术援助的目的是：增加获得豁免的处方者的数量和能力；提高处方者和多学科团队的技能；以及创造制度变革。活动包括丁丙诺啡豁免培训和提供者支持、实践促进者计划、项目回声会议、网络研讨会、临床技能培训和区域学习协作。这份综述强调了加州正在采取的步骤，以建设治疗能力，以应对阿片类药物的流行。
As part of the State Targeted Response to the opioid epidemic, California has adopted the Hub and Spoke model to expand access to medications for opioid use disorder, particularly buprenorphine, throughout the state. By aligning opioid treatment programs as hubs with primary care, office-based practitioners, and other health care settings as spokes, a broader treatment model can reach more people with opioid use disorder, improve access to medications for opioid use disorders, and decrease overdose deaths. Expanding access requires expanding knowledge and intensive implementation support of new practices. This paper describes the rationale, specific activities and anticipated impact of the implementation plan in California's Hub and Spoke system. Training and technical assistance are designed to: increase the number and capacity of waivered prescribers; enhance skills of prescribers and multidisciplinary teams; and create systems change. Activities include buprenorphine waiver trainings and provider support, a practice facilitator program, Project ECHO sessions, webinars, clinical skills trainings, and regional learning collaboratives. This overview highlights the steps California is taking to build treatment capacity to address the opioid epidemic.