Abstract：
Background: The coronavirus disease (COVID-19) pandemic has impacted patients receiving methadone maintenance treatment (MMT) through opioid treatment programs (OTPs), especially because of the unique challenges of the care delivery model. Previously, documentation of patient experiences during emergencies often comes years after the fact, in part because there is a substantial data void in real-time. Methods: We extracted 308 posts that mention COVID-19 keywords on r/methadone, an online community for patients receiving MMT to share information, on Reddit occurring between January 31, 2020 and September 30, 2020. 215 of these posts self-report an impact to their MMT. Using qualitative content analysis, we characterized the impacts described in these posts and identified four emergent themes describing patients\' experience of impacts to MMT during COVID-19. Results: The themes included (1) 54.4% of posts reporting impediments to accessing their methadone, (2) 28.4% reporting impediments to accessing physicial OTPs, (3) 19.5% reporting having to self-manage their care, and (4) 4.7% reporting impediments to accessing OTP providers and staff. Conclusions: Patients described unanticipated consequences to one-size-fits-all policies that are unevenly applied resulting in suboptimal dosing, increased perceived risk of acquiring COVID-19 at OTPs, and reduced interaction with OTP providers and staff. While preliminary, these results are formative for follow-up surveillance metrics for patients of OTPs as well as digitally-mediated resource needs for this online community. This study serves as a model of how social media can be employed during and after emergencies to hear the lived experiences of patients for informed emergency preparedness and response.
摘要：
背景：冠状病毒病（COVID-19）大流行通过阿片类药物治疗计划（OTP）影响了接受美沙酮维持治疗（MMT）的患者，特别是由于护理模式的独特挑战。以前,记录病人在紧急情况下的经历通常是在事实发生几年后，部分原因是实时存在大量数据空白。方法：我们提取了308个在r/美沙酮上提到COVID-19关键词的帖子，一个在线社区，让接受MMT的患者分享信息，在Reddit上发生在2020年1月31日至2020年9月30日之间。这些帖子中有215个自我报告对其MMT的影响。采用定性内容分析，我们对这些帖子中描述的影响进行了表征，并确定了四个紧急主题，描述了患者在COVID-19期间对MMT的影响体验。结果：主题包括（1）54.4％的帖子报告阻碍了使用美沙酮，(2)28.4%报告访问物理OTP的障碍，(3)19.5%的人报告必须自我管理他们的护理，和(4)4.7%报告阻碍接触OTP提供者和工作人员。结论：患者描述了一刀切的政策的意外后果，这些政策不均匀地应用，导致剂量欠佳。在OTP获得COVID-19的感知风险增加，减少与OTP提供商和员工的互动。虽然初步，这些结果对于OTP患者的随访监测指标以及该在线社区的数字介导资源需求具有重要意义.这项研究是如何在紧急情况期间和之后使用社交媒体来听取患者的生活经历以进行知情的紧急情况准备和响应的模型。
