Integration of a Community Opioid Treatment Program into a Federally Qualified Health Center.

IF 4.2 3区 医学 Q1 SUBSTANCE ABUSE
Christine Neeb, Brianna M McQuade, Linda Lesondak, Samantha Madrid, Judith M Schlaeger, Dennis P Watson, Niranjan Karnik, Noami Huerta, Simar Bhatia, Judes Fleurimont, Nicole Li, Elsa Hammerdahl, Ricky Pesantez, Nicole Gastala
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引用次数: 0

Abstract

Objectives: With the increasing rates of opioid overdose deaths in the United States, barriers to treatment access for patients seeking medications for opioid use disorder (OUD), and challenges of initiating buprenorphine in patients who use fentanyl, it is essential to explore novel approaches to expanding access to methadone treatment. An opioid treatment program (OTP) and a federally qualified health center (FQHC) partnered to develop and implement an innovative integrated methadone and primary care treatment model. The process for integrating an OTP and FQHC to provide methadone treatment in the primary care setting will be discussed.

Methods: An OTP methadone dispensing site was co-located in the FQHC, utilizing a staffing matrix built on the expertise of each stakeholder. The OTP managed DEA and state regulatory processes, whereas the FQHC physicians provided medical treatment, including methadone treatment protocols, treatment plans, and primary care. Patient demographics, medical history, and retention data for those who entered the program between January 2021 and February 2023 were collected through chart review and analyzed with descriptive statistics.

Results: A total of 288 OTP-FHQC patients were enrolled during the study. Retention rates in methadone treatment at 90 and 180 days were similar to partner clinics.

Conclusions: Collaboration between FQHCs and OTPs is operationally feasible and can be achieved utilizing the current staffing model of the FQHC and OTP. This model can increase access to treatment for OUD and primary care for an urban, underserved patient population.

将社区阿片类药物治疗计划纳入联邦合格医疗中心。
目标:随着美国阿片类药物过量致死率的不断上升,阿片类药物使用障碍(OUD)患者在寻求药物治疗时面临障碍,以及使用芬太尼的患者在开始使用丁丙诺啡时面临挑战,因此探索新方法以扩大美沙酮治疗的可及性至关重要。一个阿片类药物治疗项目(OTP)和一个联邦合格医疗中心(FQHC)合作开发并实施了一种创新的美沙酮和初级保健综合治疗模式。本文将讨论整合 OTP 和 FQHC,在初级保健环境中提供美沙酮治疗的过程:方法:在 FQHC 内设立了一个 OTP 美沙酮配药点,利用各利益相关方的专业知识建立了一个人员配置矩阵。OTP 负责管理 DEA 和州监管流程,而 FQHC 的医生则提供医疗服务,包括美沙酮治疗方案、治疗计划和初级保健。通过病历审查收集了在 2021 年 1 月至 2023 年 2 月期间进入项目的患者的人口统计学特征、病史和保留数据,并进行了描述性统计分析:研究期间,共有 288 名 OTP-FHQC 患者加入。美沙酮治疗 90 天和 180 天的保留率与合作诊所相似:FQHC和OTP之间的合作在操作上是可行的,可以利用FQHC和OTP目前的人员配置模式来实现。这种模式可以增加城市中服务不足的患者群体获得 OUD 治疗和初级保健的机会。
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来源期刊
Journal of Addiction Medicine
Journal of Addiction Medicine 医学-药物滥用
CiteScore
6.10
自引率
9.10%
发文量
260
审稿时长
>12 weeks
期刊介绍: The mission of Journal of Addiction Medicine, the official peer-reviewed journal of the American Society of Addiction Medicine, is to promote excellence in the practice of addiction medicine and in clinical research as well as to support Addiction Medicine as a mainstream medical sub-specialty. Under the guidance of an esteemed Editorial Board, peer-reviewed articles published in the Journal focus on developments in addiction medicine as well as on treatment innovations and ethical, economic, forensic, and social topics including: •addiction and substance use in pregnancy •adolescent addiction and at-risk use •the drug-exposed neonate •pharmacology •all psychoactive substances relevant to addiction, including alcohol, nicotine, caffeine, marijuana, opioids, stimulants and other prescription and illicit substances •diagnosis •neuroimaging techniques •treatment of special populations •treatment, early intervention and prevention of alcohol and drug use disorders •methodological issues in addiction research •pain and addiction, prescription drug use disorder •co-occurring addiction, medical and psychiatric disorders •pathological gambling disorder, sexual and other behavioral addictions •pathophysiology of addiction •behavioral and pharmacological treatments •issues in graduate medical education •recovery •health services delivery •ethical, legal and liability issues in addiction medicine practice •drug testing •self- and mutual-help.
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