Characterization of peer support services for substance use disorders in 11 US emergency departments in 2020: findings from a NIDA clinical trials network site selection process

IF 3.7 2区医学 Q1 SUBSTANCE ABUSE

Addiction Science & Clinical Practice Pub Date : 2024-04-08 DOI:10.1186/s13722-024-00453-x

Lindsey K Jennings, Laura Lander, Tricia Lawdahl, Erin A. McClure, Angela Moreland, Jenna L. McCauley, Louise Haynes, Timothy Matheson, Richard Jones, Thomas E. Robey, Sarah Kawasaki, Phillip Moschella, Amer Raheemullah, Suzette Miller, Gina Gregovich, Deborah Waltman, Kathleen T. Brady, Kelly S. Barth

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引用次数: 0

Abstract

Emergency departments (ED) are incorporating Peer Support Specialists (PSSs) to help with patient care for substance use disorders (SUDs). Despite rapid growth in this area, little is published regarding workflow, expectations of the peer role, and core components of the PSS intervention. This study describes these elements in a national sample of ED-based peer support intervention programs. A survey was conducted to assess PSS site characteristics as part of site selection process for a National Institute on Drug Abuse (NIDA) Clinical Trials Network (CTN) evaluating PSS effectiveness, Surveys were distributed to clinical sites affiliated with the 16 CTN nodes. Surveys were completed by a representative(s) of the site and collected data on the PSS role in the ED including details regarding funding and certification, services rendered, role in medications for opioid use disorder (MOUD) and naloxone distribution, and factors impacting implementation and maintenance of ED PSS programs. Quantitative data was summarized with descriptive statistics. Free-text fields were analyzed using qualitative content analysis. A total of 11 surveys were completed, collected from 9 different states. ED PSS funding was from grants (55%), hospital funds (46%), peer recovery organizations (27%) or other (18%). Funding was anticipated to continue for a mean of 16 months (range 12 to 36 months). The majority of programs provided “general recovery support (81%) Screening, Brief Intervention, and Referral to Treatment (SBIRT) services (55%), and assisted with naloxone distribution to ED patients (64%). A minority assisted with ED-initiated buprenorphine (EDIB) programs (27%). Most (91%) provided services to patients after they were discharged from the ED. Barriers to implementation included lack of outpatient referral sources, barriers to initiating MOUD, stigma at the clinician and system level, and lack of ongoing PSS availability due to short-term grant funding. The majority of ED-based PSSs were funded through time-limited grants, and short-term grant funding was identified as a barrier for ED PSS programs. There was consistency among sites in the involvement of PSSs in facilitation of transitions of SUD care, coordination of follow-up after ED discharge, and PSS involvement in naloxone distribution.

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2020 年美国 11 个急诊科药物使用障碍同伴支持服务的特点：NIDA 临床试验网络选址过程中的发现

急诊科（ED）正在引入同伴支持专家（PSS），以帮助患者治疗药物使用障碍（SUD）。尽管这一领域发展迅速，但有关工作流程、对同伴角色的期望以及 PSS 干预措施的核心内容却鲜有报道。本研究描述了基于急诊室的同伴支持干预项目的全国样本中的这些要素。作为美国国家药物滥用研究所（NIDA）临床试验网络（CTN）评估同伴支持计划有效性的选点过程的一部分，我们进行了一项调查，以评估同伴支持计划的选点特征。调查表由研究机构的一名（或多名）代表填写，收集了有关 PSS 在 ED 中的作用的数据，包括有关资金和认证、提供的服务、在治疗阿片类药物使用障碍 (MOUD) 和纳洛酮分发中的作用以及影响 ED PSS 计划实施和维护的因素等方面的详细信息。定量数据通过描述性统计进行总结。自由文本字段采用定性内容分析法进行分析。从 9 个不同的州共收集到 11 份调查问卷。ED PSS 的资金来源包括拨款（55%）、医院资金（46%）、同伴康复组织（27%）或其他（18%）。预计资助平均持续 16 个月（12 至 36 个月）。大多数项目提供 "一般康复支持（81%）、筛查、简单干预和转介治疗（SBIRT）服务（55%），并协助向急诊室患者分发纳洛酮（64%）。少数人协助开展了由急诊室发起的丁丙诺啡（EDIB）计划（27%）。大多数机构（91%）在急诊室病人出院后为其提供服务。实施的障碍包括缺乏门诊转介来源、启动 MOUD 的障碍、临床医生和系统层面的耻辱感，以及由于短期拨款资助而缺乏持续的 PSS 可用性。大多数基于急诊室的 PSS 是通过有时间限制的拨款资助的，短期拨款资助被认为是急诊室 PSS 项目的障碍。在促进 SUD 护理过渡、协调 ED 出院后的随访以及 PSS 参与纳洛酮分发等方面，各研究机构的 PSS 参与情况是一致的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Addiction Science & Clinical Practice Psychology-Clinical Psychology

CiteScore

3.90

自引率

10.80%

发文量

审稿时长

28 weeks

期刊介绍： Addiction Science & Clinical Practice provides a forum for clinically relevant research and perspectives that contribute to improving the quality of care for people with unhealthy alcohol, tobacco, or other drug use and addictive behaviours across a spectrum of clinical settings. Addiction Science & Clinical Practice accepts articles of clinical relevance related to the prevention and treatment of unhealthy alcohol, tobacco, and other drug use across the spectrum of clinical settings. Topics of interest address issues related to the following: the spectrum of unhealthy use of alcohol, tobacco, and other drugs among the range of affected persons (e.g., not limited by age, race/ethnicity, gender, or sexual orientation); the array of clinical prevention and treatment practices (from health messages, to identification and early intervention, to more extensive interventions including counseling and pharmacotherapy and other management strategies); and identification and management of medical, psychiatric, social, and other health consequences of substance use. Addiction Science & Clinical Practice is particularly interested in articles that address how to improve the quality of care for people with unhealthy substance use and related conditions as described in the (US) Institute of Medicine report, Improving the Quality of Healthcare for Mental Health and Substance Use Conditions (Washington, DC: National Academies Press, 2006). Such articles address the quality of care and of health services. Although the journal also welcomes submissions that address these conditions in addiction speciality-treatment settings, the journal is particularly interested in including articles that address unhealthy use outside these settings, including experience with novel models of care and outcomes, and outcomes of research-practice collaborations. Although Addiction Science & Clinical Practice is generally not an outlet for basic science research, we will accept basic science research manuscripts that have clearly described potential clinical relevance and are accessible to audiences outside a narrow laboratory research field.