Creation of a telehealth addiction consultation service at a rural hospital: a case study.

IF 3.2 2区 医学 Q1 SUBSTANCE ABUSE
Rachel Katz, Tiarra Fisher, Talia Singer-Clark, William Soares Iii, Jane Carpenter, Nadia Schuessler, Henry Stadler, Andrea Sahovey, Ann Scheck McAlearney, Jeffrey H Samet, Avik Chatterjee
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引用次数: 0

Abstract

Background: Rural communities face significant barriers to accessing substance use disorder (SUD) treatment, resulting in gaps in care and increased rates of opioid-related overdose deaths. Hospital-based Addiction Consult Services (ACS) improve outcomes for patients with SUD, but rural hospitals often lack these services.

Case presentation: The Community Addiction Consult (CAC) service was established at a rural hospital in western Massachusetts to address this gap. CAC was designed by a community coalition comprised of a diverse cross-section of the community in which the hospital is based, using opioid-overdose data from the region to inform their decisions. Using a telehealth model, the CAC provided evidence-based treatments to support hospital staff treating patients with opioid use disorder (OUD) or requiring addiction-related care. From April 2023 through December 2023, the CAC provided 36 consults, facilitating increased access to medications for opioid use disorder (MOUD), and enhancing provider confidence in treating people who use drugs (PWUD) and initiating MOUD. An average of 22 patients received MOUD as inpatients monthly, and 11 emergency department patients received MOUD monthly. The CAC team also implemented training sessions, and an anti-stigma campaign to familiarize hospital staff with harm reduction principles and person-centered care strategies to foster a more supportive treatment environment for PWUD.

Conclusions: The Community Addiction Consult service demonstrates the feasibility and efficacy of a telehealth Addiction Consult Service model. Paired with staff trainings, such a model can bridge the gaps in rural addiction care. By leveraging local expertise and data-driven approaches, this model offers a scalable, equitable solution to improving access to substance use disorder treatment in rural settings.

Abstract Image

在农村医院建立远程医疗成瘾咨询服务:案例研究。
背景:农村社区在获得药物使用障碍(SUD)治疗方面面临重大障碍,导致护理差距和阿片类药物相关过量死亡率上升。基于医院的成瘾咨询服务(ACS)改善了SUD患者的预后,但农村医院往往缺乏这些服务。案例介绍:社区成瘾咨询(CAC)服务是在马萨诸塞州西部的一家农村医院建立的,以解决这一差距。CAC是由一个社区联盟设计的,该联盟由医院所在社区的不同横截面组成,使用该地区的阿片类药物过量数据来为他们的决策提供信息。CAC利用远程保健模式提供循证治疗,以支持医院工作人员治疗阿片类药物使用障碍患者或需要成瘾相关护理的患者。从2023年4月到2023年12月,CAC提供了36次咨询,促进了阿片类药物使用障碍(mod)药物的获得,并增强了提供者对治疗吸毒者(PWUD)和启动mod的信心。平均每月住院22例患者接受mod治疗,急诊11例患者接受mod治疗。CAC小组还开展了培训课程和反污名运动,使医院工作人员熟悉减少伤害原则和以人为本的护理战略,从而为PWUD营造一个更支持性的治疗环境。结论:社区成瘾咨询服务显示了远程医疗成瘾咨询服务模式的可行性和有效性。与工作人员培训相结合,这种模式可以弥合农村成瘾护理方面的差距。通过利用当地专业知识和数据驱动的方法,该模式为改善农村环境中物质使用障碍治疗的可获得性提供了可扩展的、公平的解决方案。
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来源期刊
Addiction Science & Clinical Practice
Addiction Science & Clinical Practice Psychology-Clinical Psychology
CiteScore
3.90
自引率
10.80%
发文量
64
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.
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