评估以药剂师为主导的新型丁丙诺啡外联服务,以治疗居住在支持性住房中的个人的阿片类药物使用失调症

IF 1.3 Q4 PHARMACOLOGY & PHARMACY
Janice Ly Pharm.D., Damian Peterson Pharm.D., Michelle Geier Pharm.D.
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引用次数: 0

摘要

仅在 2022 年,旧金山就有 638 例因阿片类药物过量而意外死亡的案例,其中黑人和有固定住房的人群中阿片类药物过量的比例过高。过去试图解决这种差异的研究表明,低门槛丁丙诺啡(BUP)治疗模式可以提高边缘化人群的患者参与度和保留率。这是一项为期 3 个月的前后干预试点研究,旨在评估由药剂师主导的新型外展服务对患者参与丁丙诺啡治疗阿片类药物使用障碍(OUD)的影响。主要终点是治疗依从性,即 3 个月内 80% 的处方天数(PDC)。次要终点包括处方天数的变化、与诊室护理的联系、用药过量发生率、急诊科(ED)就诊率和入院率,以及 BUP 的成功启动率。在 38 名患者中,平均年龄为 46 岁,16 人(42%)为黑人。参与该服务与治疗依从性的提高有关,干预后有14名患者(37%)的PDC达到≥80%,而干预前只有1名患者(3%)(p = 0.0009)。低门槛的BUP治疗模式,如本研究中评估的模式,可能有助于提供更公平、更方便的医疗服务,这对解决阿片类药物过量死亡的社会经济和种族差异问题至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evaluating a novel pharmacist-led buprenorphine outreach service for treatment of opioid use disorder in individuals residing in supportive housing

Introduction

In San Francisco, there were 638 accidental overdose deaths involving opioids in 2022 alone, with opioid overdoses occurring at a disproportionate rate in the Black population and in those with fixed housing. Past studies attempting to address such disparities suggest that low-barrier buprenorphine (BUP) treatment models may improve patient engagement and retention in care for marginalized populations. While such models have been studied among persons experiencing houselessness (PEH), less is known about the effects of such treatment models among individuals residing in permanent supportive housing (PSH).

Objectives

To evaluate the impact of an innovative pharmacist-led pilot service in providing more equitable and accessible BUP treatment to individuals residing in PSH.

Methods

This was a 3-month pre-and-post interventional pilot study to evaluate the impact of a novel pharmacist-led outreach service on patient engagement in treatment with BUP for Opioid Use Disorder (OUD). The primary endpoint was treatment adherence, defined as 80% prescription days covered (PDC) in a 3-month period. Secondary endpoints included change in PDC, linkage to office-based care, incidence of overdose, emergency department (ED) presentations, and hospital admissions, as well as successful BUP initiation.

Results

Thirty-eight patients were enrolled in the pharmacist-led BUP outreach service. Among the 38 patients, the mean age was 46 years and 16 (42%) were Black. Engagement with the service was associated with increased treatment adherence, with 14 patients (37%) achieving ≥80% PDC post-intervention compared to 1 patient (3%) pre-intervention (p = 0.0009).

Conclusion

A pharmacist-led BUP outreach service was found to increase treatment adherence in individuals residing in PSH over 3 months. Low-barrier BUP treatment models, such as that evaluated in this study, may help provide more equitable and accessible care that is critical in addressing the socioeconomic and racial disparities in opioid overdose deaths.

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CiteScore
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