对解决健康的社会决定因素及其对阿片类药物使用障碍结果的影响的干预措施进行范围审查

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence Pub Date : 2025-09-08 DOI:10.1016/j.drugalcdep.2025.112858

Sarah J. Cousins , Chunqing Lin , Yuhui Zhu , Sarah E. Clingan , Larissa J. Mooney , Layla Tondravi , Fei Wu , Yih-Ing Hser

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引用次数: 0

摘要

在过去十年中，阿片类药物过量死亡人数急剧增加。健康的社会决定因素（SDOH）框架可以指导改善阿片类药物使用障碍（OUD）结果的干预措施。目前还没有关于SDOH干预措施及其对OUD结果影响的全面综述。这个范围审查解决了这个差距。方法从PubMed、Embase、Web of Science和Cochrane数据库中提取文章。干预措施按SDOH领域分类：卫生保健系统、社会和社区环境、邻里环境、经济稳定和教育。总结了干预措施和OUD结果（例如，治疗开始、阿片类药物使用、过量）。结果27项同行评议的研究针对SDOH域。医疗保健系统领域（37%的研究）是最常涉及的，重点是提供者培训，获取和护理质量的改善，其结果是增加了OUD药物的开始，减少了阿片类药物的使用，减少了提供者的耻辱感。社区和社会背景（30%）干预措施包括社会支持计划和社区联盟，减少阿片类药物使用、过量使用和社区层面的耻辱。经济稳定（16%）干预措施包括以就业为基础的加强和促进禁欲的财政激励。社区和自然环境干预措施（9%）包括减少阿片类药物使用的住房优先倡议。在教育领域（2%），早期教育干预降低了成年期OUD的风险。超过一半的研究（52%）采用随机设计；其余的使用准实验方法。差距包括SDOH干预措施范围有限，SDOH的定义和测量不一致，以及缺乏严格的评估。结论未来的研究应统一SDOH术语和指标，严格评估SDOH干预效果，扩大SDOH干预范围。

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A scoping review of interventions addressing social determinants of health and their influence on opioid use disorder outcomes

Background

Over the past decade, opioid overdose deaths have sharply increased. The Social Determinants of Health (SDOH) framework can guide interventions to improve opioid use disorder (OUD) outcomes. No comprehensive review of SDOH interventions and their impacts on OUD outcomes is available. This scoping review addresses that gap.

Methods

We extracted articles from PubMed, Embase, Web of Science, and Cochrane databases. Interventions were categorized according to SDOH domains: healthcare system, social and community context, neighborhood environment, economic stability, and education. Interventions and OUD outcomes (e.g., treatment initiation, opioid use, overdose) were summarized.

Results

Twenty-seven peer-reviewed studies targeted SDOH domains. The healthcare system domain (37 % of studies) was the most frequently addressed, focusing on provider training, access, and quality-of-care improvements with outcomes like increased initiation of medication for OUD, reduced opioid use, and reduced provider stigma. Community and social context (30 %) interventions included social support programs and community coalitions that reduced opioid use, overdose, and community-level stigma. Economic stability (16 %) interventions included employment-based reinforcements and financial incentives to promote abstinence. Neighborhood and physical environment (9 %) interventions included Housing-First initiatives that reduced opioid use. In the education domain (2 %), an early education intervention reduced adulthood OUD risk. Over half of all studies (52 %) used randomized designs; the remainder used quasi-experimental approaches. Gaps included a limited range of SDOH interventions, inconsistent definitions and measurements of SDOH, and a lack of rigorous evaluations.

Conclusion

Future research should harmonize SDOH terminology and metrics, rigorously assess SDOH intervention outcomes, and expand the range of SDOH interventions.

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来源期刊

Drug and alcohol dependence 医学-精神病学

CiteScore

7.40

自引率

7.10%

发文量

409

审稿时长

41 days

期刊介绍： Drug and Alcohol Dependence is an international journal devoted to publishing original research, scholarly reviews, commentaries, and policy analyses in the area of drug, alcohol and tobacco use and dependence. Articles range from studies of the chemistry of substances of abuse, their actions at molecular and cellular sites, in vitro and in vivo investigations of their biochemical, pharmacological and behavioural actions, laboratory-based and clinical research in humans, substance abuse treatment and prevention research, and studies employing methods from epidemiology, sociology, and economics.