Shifting Medication Treatment Practices in the COVID-19 Pandemic: A Statewide Survey of Pennsylvania Opioid Treatment Programs.

Autor:	Krawczyk N; From the Center for Opioid Epidemiology and Policy, Department of Population Health, NYU Grossman School of Medicine, New York, NY (NK); Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (HM, BS); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (EAS; SB); Vital Strategies, New York, NY (EH); and Pennsylvania Department of Drug and Alcohol Programs, Harrisburg, PA (JSS, ED)., Maniates H, Hulsey E, Smith JS, DiDomenico E, Stuart EA, Saloner B, Bandara S
Jazyk:	angličtina
Zdroj:	Journal of addiction medicine [J Addict Med] 2022 Nov-Dec 01; Vol. 16 (6), pp. 645-652.
DOI:	10.1097/ADM.0000000000000981
Abstrakt:	Objectives: We sought to understand how opioid treatment programs (OTPs) adapted OTP operations to the COVID-19 pandemic and new federal regulations around methadone and buprenorphine. Methods: In fall 2020, we conducted an online survey of all 103 OTPs licensed by the Pennsylvania Department of Drug and Alcohol Programs, including clinical directors. Survey domains included changes to methadone take-home and telehealth practices; overdose and diversion prevention tactics; perceptions regarding how such changes influence patient well-being; and financial/operational concerns related to the new policies and practices. We calculated descriptive statistics and conducted Chi-square test to test for differences between not-for-profit versus for-profit and large versus small OTPs. Results: Forty-seven percent (46%) OTPs responded to the survey. 10% and 25%, respectively, endorsed offering telephone and video-based telemedicine buprenorphine induction. Sixty-six percent endorsed extending take-home supplies of methadone, but most indicated that these extensions applied to a minority of their patients. Most respondents agreed that provision of buprenorphine via telehealth and extended take-home methadone reduced patient burden in accessing medications and prevented exposure to COVID-19, while not significantly increasing risk of overdose. We did not find major differences in COVID-19 practice modifications by nonprofit status or size of OTP. Conclusions: In Pennsylvania, the COVID-19 pandemic led to rapid changes in provision of opioid treatment services. Findings on relatively low uptake of longer methadone take-home regimens and virtual buprenorphine initiation despite general support for these practices imply a need to further develop guidelines for best clinical practices and understand/address barriers to their implementation. Competing Interests: The authors report no conflicts of interest. (Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Society of Addiction Medicine.)
Databáze:	MEDLINE
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