Primary Care-Based Models for the Treatment of Opioid Use Disorder: A Scoping Review.
Primary Care-Based Models for the Treatment of Opioid Use Disorder: A Scoping Review.
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DOI：
10.7326/m16-2149
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发表时间：
2017-02-21
影响因子：
39.2
通讯作者：
Chou R
中科院分区：
文献类型：
--
作者：
Korthuis PT;McCarty D;Weimer M;Bougatsos C;Blazina I;Zakher B;Grusing S;Devine B;Chou R
在美国初级保健机构中进一步整合阿片类药物使用障碍 (OUD) 的药物辅助治疗 (MAT) 将扩大这种疾病的治疗范围。将 MAT 纳入初级保健的模型因其结构方式而异。本文根据文献综述和对该领域主要知情人的采访，总结了医疗保健研究和质量局 (AHRQ) 描述 OUD MAT 护理模型的技术报告的调查结果。该报告描述了将 MAT 纳入初级保健环境的 12 种代表性护理模式，可以考虑将其适应不同的医疗保健环境。现有护理模式的常见组成部分包括 (1) 丁丙诺啡或纳曲酮药物治疗，(2) 提供者和社区教育，(3) OUD 与其他医疗/心理需求的协调/整合，以及 (4) 心理社会服务/干预措施。模型因每个组件的实现方式而异。关于采用 MAT 护理模式的决定应因人而异，以适应每个实施环境的独特环境。
Greater integration of medication-assisted treatment (MAT) for opioid use disorder (OUD) in U.S. primary care settings would expand access to treatment for this condition. Models for integrating MAT in primary care vary in how they are structured. This paper summarizes findings of a technical report for the Agency for Healthcare Research and Quality (AHRQ) describing OUD MAT models of care, based on a literature review and interviews with key informants in the field. The report describes 12 representative models of care for integrating MAT in primary care settings that could be considered for adaptation across diverse healthcare settings. Common components of existing care models include (1) pharmacotherapy with buprenorphine or naltrexone, (2) provider and community education, (3) coordination/integration of OUD with other medical/psychological needs, and (4) psychosocial services/interventions. Models varied with respect to how each component is implemented. Decisions about adopting MAT models of care should be individualized to address the unique milieu of each implementation setting.