Abstract：
OBJECTIVE: Legal regulations for dispensing in Swiss heroin-assisted treatment were relaxed during the COVID-19 pandemic, allowing prolonged take-home of up to 7 days instead of two to reduce patient contact and the risk of infection. Our study aimed to measure the consequences of this new practice.
METHODS: This was a retrospective cohort study set in Switzerland\'s largest outpatient centre for opioid agonist therapy. One hundred and thirty-four (72.4%) of the 185 patients receiving oral diacetylmorphine (DAM) participated in the study.
METHODS: Through the utilization of electronic medication prescription and dispensing software, as well as the electronic medical record, the following data were extracted to explore the potential consequences: dose of DAM, the number of antibiotic therapies, emergency hospitalizations and incarcerations. Age, gender, prescriptions for psychotrophic drugs and additional prescription for injectable DAM were tested to assess an increased risk of losing prolonged take-home privileges. Data in the year since prolonged take-home (period 2) were compared with data from the equivalent prior year (period 1).
RESULTS: DAM take-home was not associated with a change in DAM dose (P = 0.548), the number of emergency hospitalizations (P = 0.186) or the number of incarcerations (P = 0.215); 79.1% of all patients were able to maintain their extended take-home privileges. However, patients who had injectable DAM experienced significant reductions in their prolonged take-home privileges.
CONCLUSIONS: Allowing patients to take home oral diacetylmorphine for up to 7 days as treatment for opioid use disorder does not appear to pose any demonstrable health risk. It is generally manageable for the large majority of patients. However, careful consideration of prolonged take-home for patients with additional injectable diacetylmorphine is recommended, as these patients are more likely to lose take-home privileges.
METHODS: This was a retrospective cohort study set in Switzerland\'s largest outpatient centre for opioid agonist therapy. One hundred and thirty-four (72.4%) of the 185 patients receiving oral diacetylmorphine (DAM) participated in the study.
METHODS: Through the utilization of electronic medication prescription and dispensing software, as well as the electronic medical record, the following data were extracted to explore the potential consequences: dose of DAM, the number of antibiotic therapies, emergency hospitalizations and incarcerations. Age, gender, prescriptions for psychotrophic drugs and additional prescription for injectable DAM were tested to assess an increased risk of losing prolonged take-home privileges. Data in the year since prolonged take-home (period 2) were compared with data from the equivalent prior year (period 1).
RESULTS: DAM take-home was not associated with a change in DAM dose (P = 0.548), the number of emergency hospitalizations (P = 0.186) or the number of incarcerations (P = 0.215); 79.1% of all patients were able to maintain their extended take-home privileges. However, patients who had injectable DAM experienced significant reductions in their prolonged take-home privileges.
CONCLUSIONS: Allowing patients to take home oral diacetylmorphine for up to 7 days as treatment for opioid use disorder does not appear to pose any demonstrable health risk. It is generally manageable for the large majority of patients. However, careful consideration of prolonged take-home for patients with additional injectable diacetylmorphine is recommended, as these patients are more likely to lose take-home privileges.
摘要：
目的：在COVID-19大流行期间，瑞士海洛因辅助治疗的配药法律法规有所放松，允许长达7天而不是2天的长时间带回家，以减少患者接触和感染的风险。我们的研究旨在衡量这种新做法的后果。
方法：这是一项在瑞士最大的阿片类药物激动剂治疗门诊中心进行的回顾性队列研究。接受口服二乙酰吗啡（DAM）的185名患者中有134名（72.4％）参加了该研究。
方法：通过使用电子处方和配药软件，以及电子病历，提取以下数据来探索潜在的后果：DAM的剂量，抗生素治疗的数量，紧急住院和监禁。年龄,性别,我们对精神营养药物的处方和可注射DAM的额外处方进行了测试,以评估失去长期带回家特权的风险增加.将自延长带回家（第2期）以来的当年数据与前一年（第1期）的数据进行比较。
结果：DAM带回家与DAM剂量的变化无关（P=0.548），急诊住院次数(P=0.186)或监禁次数(P=0.215);所有患者中有79.1%能够维持延长的带回家特权.然而,接受可注射DAM的患者的长期带回家特权显著减少.
结论：允许患者回家口服二乙酰吗啡长达7天，因为阿片类药物使用障碍的治疗似乎不会造成任何明显的健康风险。对于大多数患者来说，这通常是可控的。然而,对于额外注射二乙酰吗啡的患者，建议仔细考虑延长带回家，因为这些患者更有可能失去回家的特权。
方法：这是一项在瑞士最大的阿片类药物激动剂治疗门诊中心进行的回顾性队列研究。接受口服二乙酰吗啡（DAM）的185名患者中有134名（72.4％）参加了该研究。
方法：通过使用电子处方和配药软件，以及电子病历，提取以下数据来探索潜在的后果：DAM的剂量，抗生素治疗的数量，紧急住院和监禁。年龄,性别,我们对精神营养药物的处方和可注射DAM的额外处方进行了测试,以评估失去长期带回家特权的风险增加.将自延长带回家（第2期）以来的当年数据与前一年（第1期）的数据进行比较。
结果：DAM带回家与DAM剂量的变化无关（P=0.548），急诊住院次数(P=0.186)或监禁次数(P=0.215);所有患者中有79.1%能够维持延长的带回家特权.然而,接受可注射DAM的患者的长期带回家特权显著减少.
结论：允许患者回家口服二乙酰吗啡长达7天，因为阿片类药物使用障碍的治疗似乎不会造成任何明显的健康风险。对于大多数患者来说，这通常是可控的。然而,对于额外注射二乙酰吗啡的患者，建议仔细考虑延长带回家，因为这些患者更有可能失去回家的特权。
