M. Incze, Sophia Huebler, Sean Grant, Adam J. Gordon
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引用次数: 0
摘要
越来越多的人认识到,医疗住院是接触药物使用障碍(SUD)患者并提供治疗的重要机会。虽然越来越多的医院已采取干预措施,支持在患者入院期间提供药物滥用治疗,但住院后的护理过渡仍是患者和临床医生面临的一项挑战,也是药物滥用治疗中未得到充分研究的一个领域。目前还缺乏有关最有效、最可行的护理模式的证据,以改善 SUD 患者入院后的护理过渡。在缺乏强有力的实证证据来指导实践和政策的情况下,德尔菲流程等基于共识的研究方法可以发挥重要作用,有效地确定现有护理模式的优先次序,供未来研究和实施。我们开展了一项德尔菲研究,召集了 25 位具有直接临床经验的国内跨学科专家,为患有精神分裂症的患者提供住院后护理过渡服务。我们的专家小组成员根据 GRADE "从证据到决策"(Evidence to Decision)框架,按照预期效果和实施设施对 10 种现有的护理过渡模式进行了评级。我们还通过评论和在线主持讨论板收集了每种护理模式的定性数据。我们的研究结果有助于建立 SUD 护理过渡模式的层次结构,为今后的研究和项目开发提供参考。
Using the Delphi Process to Prioritize an Agenda for Care Transition Research for Patients With Substance Use Disorders.
Medical hospitalizations are increasingly recognized as important opportunities to engage individuals with substance use disorders (SUD) and offer treatment. While a growing number of hospitals have instituted interventions to support the provision of SUD care during medical admissions, post-hospitalization transitions of care remain a challenge for patients and clinicians and an understudied area of SUD care. Evidence is lacking on the most effective and feasible models of care to improve post-hospitalization care transitions for people with SUD. In the absence of strong empirical evidence to guide practice and policy, consensus-based research methods such as the Delphi process can play an important role in efficiently prioritizing existing models of care for future study and implementation. We conducted a Delphi study that convened a group of 25 national interdisciplinary experts with direct clinical experience facilitating post-hospitalization care transitions for people with SUD. Our panelists rated 10 existing care transition models according to anticipated effectiveness and facility of implementation based on the GRADE Evidence to Decision framework. Qualitative data on each care model were also gathered through comments and an online moderated discussion board. Our results help establish a hierarchy of SUD care transition models to inform future study and program development.