Adaptation of the Tele-Harm Reduction intervention to promote initiation and retention in buprenorphine treatment among people who inject drugs: a retrospective cohort study.

IF 4.9 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Edward Suarez, Tyler S Bartholomew, Marina Plesons, Katrina Ciraldo, Lily Ostrer, David P Serota, Teresa A Chueng, Morgan Frederick, Jason Onugha, Hansel E Tookes
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引用次数: 0

Abstract

Background: At the start of the pandemic, relaxation of buprenorphine prescribing regulations created an opportunity to create new models of medications for opioid use disorder (MOUD) delivery and care. To expand and improve access to MOUD, we adapted and implemented the Tele-Harm Reduction (THR) intervention; a multicomponent, telehealth-based and peer-driven intervention to promote HIV viral suppression among people who inject drugs (PWID) accessing a syringe services program (SSP). This study examined buprenorphine initiation and retention among PWID with opioid use disorder who received the adapted THR intervention at the IDEA Miami SSP.Methods: A retrospective chart review of participants who received the THR intervention for MOUD was performed to examine the impact of telehealth on buprenorphine retention. Our primary outcome was three-month retention, defined as three consecutive months of buprenorphine dispensed from the pharmacy.Results: A total of 109 participants received the adapted THR intervention. Three-month retention rate on buprenorphine was 58.7%. Seeing a provider via telehealth at baseline or any follow up visit (aOR = 7.53, 95% CI: [2.36, 23.98]) and participants who had received an escalating dose of buprenorphine after baseline visit (aOR = 8.09, 95% CI: [1.83, 35.87]) had a higher adjusted odds of retention at three months. Participants who self-reported or tested positive for a stimulant (methamphetamine, amphetamine, or cocaine) at baseline had a lower adjusted odds of retention on buprenorphine at three months (aOR = 0.29, 95% CI: [0.09, 0.93]).Conclusions: Harm reduction settings can adapt dynamically to the needs of PWID in provision of critical lifesaving buprenorphine in a truly destigmatising approach. Our pilot suggests that an SSP may be an acceptable and feasible venue for delivery of THR to increase uptake of buprenorphine by PWID and promote retention in care.KEY MESSAGESThe Tele-Harm Reduction intervention can be adapted for initiating and retaining people who inject drugs with opioid use disorder on buprenorphine within a syringe services program settingUsing telehealth was associated with increased three-month buprenorphine retentionBaseline stimulant use was negatively associated with three-month buprenorphine retention.

适应远程减少伤害干预以促进注射吸毒者开始和保持丁丙诺啡治疗:一项回顾性队列研究。
背景:在疫情开始时,丁丙诺啡处方规定的放松为创建阿片类药物使用障碍(MOOD)药物递送和护理的新模式创造了机会。为了扩大和改善MOUD的使用,我们调整并实施了减少远程伤害(THR)干预措施;一种多成分、基于远程健康和同伴驱动的干预措施,旨在促进注射药物(PWID)的人对获得注射器服务计划(SSP)的HIV病毒的抑制。本研究调查了在IDEA迈阿密SSP接受适应性THR干预的阿片类药物使用障碍PWID患者的丁丙诺啡起始和保留情况。我们的主要结果是三个月的滞留,定义为连续三个月从药房配药的丁丙诺啡。结果:共有109名参与者接受了适应性THR干预。丁丙诺啡的三个月保留率为58.7%。在基线或任何随访时通过远程医疗就诊(aOR=7.53,95%CI:[2.36,23.98])和在基线随访后接受递增剂量丁丙诺菲的参与者(aOR=8.09,95%CI:[1.83,35.87]),在三个月时的调整后保留几率更高 月。在基线时自我报告或检测出兴奋剂(甲基苯丙胺、苯丙胺或可卡因)呈阳性的参与者在三岁时丁丙诺啡滞留的调整后几率较低 月(aOR=0.29,95%CI:[0.09,0.93])。结论:减少伤害的设置可以动态适应PWID的需求,以真正消除污名化的方法提供关键的救命丁丙诺啡。我们的试验表明,SSP可能是一种可接受和可行的THR递送场所,以增加PWID对丁丙诺啡的吸收并促进护理中的滞留。关键信息减少远程伤害干预可适用于在注射器服务项目设置中启动和保留使用丁丙诺啡注射阿片类药物使用障碍药物的人。使用远程医疗与三个月丁丙诺吗啡保留增加有关。基线兴奋剂使用与三个个月丁丁丙诺菲保留呈负相关。
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来源期刊
Annals of medicine
Annals of medicine 医学-医学:内科
CiteScore
4.90
自引率
0.00%
发文量
292
审稿时长
3 months
期刊介绍: Annals of Medicine is one of the world’s leading general medical review journals, boasting an impact factor of 5.435. It presents high-quality topical review articles, commissioned by the Editors and Editorial Committee, as well as original articles. The journal provides the current opinion on recent developments across the major medical specialties, with a particular focus on internal medicine. The peer-reviewed content of the journal keeps readers updated on the latest advances in the understanding of the pathogenesis of diseases, and in how molecular medicine and genetics can be applied in daily clinical practice.
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