Increasing Initiation of Medications for Opioid Use Disorder Through Recovery Coaches: The Role of Implementation Setting.

IF 4.2 3区医学 Q1 SUBSTANCE ABUSE

Journal of Addiction Medicine Pub Date : 2025-03-18 DOI:10.1097/ADM.0000000000001482

Hannah K Knudsen, Amanda Fallin-Bennett, Laura Fanucchi, Michelle R Lofwall, Margaret McGladrey, Carrie B Oser, Gary Biggers, Anna Ross, Jimmy Chadwell, Sharon L Walsh

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引用次数: 0

Abstract

Objectives: Programs to increase linkage to medications for opioid use disorder (MOUD) through peer recovery coaches may hold promise in increasing MOUD initiation. However, the impact of linkage programs may vary based on contextual factors, such as the implementation setting. This study examines whether implementation setting is associated with MOUD initiation following participation in peer-based linkage programs.

Methods: The University of Kentucky and Voices of Hope Lexington, a recovery community organization, trained recovery coaches to implement a MOUD linkage program. Coaches were deployed in 9 criminal-legal organizations (ie, jails, specialty court, and pretrial services) and 20 community organizations in 4 rural and 4 urban counties. Coaches worked with participants (n = 754) to set person-centered goals, provided MOUD education, addressed MOUD initiation barriers, and assisted with scheduling appointments. A typology of implementation setting categorized participants by where they enrolled in the linkage program: (1) urban community organizations (reference group), (2) urban criminal-legal organizations, (3) rural community organizations, or (4) rural criminal-legal organizations. The odds of MOUD initiation were estimated using multivariate logistic regression.

Results: Of 754 participants, 23.1% (n = 174) reported initiating MOUD. Relative to urban community organizations, individuals enrolled in rural community organizations were more likely to initiate MOUD (odds ratio = 1.85, P = 0.04), whereas individuals enrolled in rural criminal-legal organizations were less likely to initiate MOUD (odds ratio = 0.34, P = 0.005).

Conclusions: Implementation setting may impact the likelihood of MOUD initiation through peer-based linkage programs. Future research should examine how implementation strategies might overcome setting-specific barriers to MOUD initiation, particularly in rural criminal-legal settings.

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通过康复教练增加阿片类药物使用障碍的开始：实施环境的作用。

目的：通过同伴康复教练增加与阿片类药物使用障碍（mod）药物的联系的计划可能有望增加mod的启动。然而，联动项目的影响可能会因环境因素而异，比如实施环境。本研究探讨了实施环境是否与参与基于同伴的联系项目后的mod启动有关。在4个农村县和4个城市县的9个刑事法律组织（即监狱、专业法院和审前服务）和20个社区组织中部署了教练。教练与参与者（n = 754）一起设定以人为本的目标，提供mod教育，解决mod入门障碍，并协助安排预约。实施环境的类型学根据参与者参加联系项目的地点对参与者进行分类：(1)城市社区组织（参照组），(2)城市刑事法律组织，(3)农村社区组织，或(4)农村刑事法律组织。使用多变量逻辑回归估计mod发生的几率。结果：在754名参与者中，23.1% （n = 174）报告开始了mod。相对于城市社区组织，参加农村社区组织的个体更有可能发起mod（优势比= 1.85,P = 0.04），而参加农村刑事法律组织的个体发起mod的可能性更小（优势比= 0.34,P = 0.005）。结论：实施环境可能会影响通过基于同伴的联系项目发起mod的可能性。未来的研究应检查实施策略如何克服特定环境下启动mod的障碍，特别是在农村刑事法律环境中。

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

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.