PDF(Pubmed)
Abstract：
BACKGROUND: Overdose deaths continue to rise within the United States, despite effective treatments such as buprenorphine and methadone for opioid use disorder (OUD). Mobile medical units with the ability to dispense buprenorphine have been developed to engage patients and eliminate barriers to accessing OUD treatment. This study reports survey responses of patients of a mobile medical unit dispensing buprenorphine in areas of Chicago, IL with high overdose rates.
METHODS: All patients who were dispensed buprenorphine via the mobile medical unit were invited to participate in a 7-item anonymous survey between May 24, 2023, and August 25, 2023. The survey included 5-point satisfaction scale, multiple-choice, and open-ended questions. Outcomes included satisfaction with buprenorphine dispensing from the mobile medical unit, satisfaction with filling buprenorphine at a pharmacy in the past, barriers experienced at pharmacies when filling buprenorphine, and whether the client would have started treatment that day if the mobile medical unit had not been present. Satisfaction scale and multiple-choice question responses were assessed using descriptive statistics. Wilcoxon signed-rank test was used to compare median satisfaction levels between receiving buprenorphine from the mobile medical unit versus filling a buprenorphine prescription at a community pharmacy. Open-ended questions were analyzed qualitatively using inductive thematic analysis.
RESULTS: 106 unique patients were dispensed buprenorphine from the mobile unit during the study period. Of these patients, 54 (51%) completed the survey. Respondents reported high satisfaction with the buprenorphine dispensing process as a part of a mobile medical unit. Of those who had previously filled buprenorphine at a pharmacy, 83% reported at least one barrier, with delays in prescription dispensing from a community pharmacy, lack of transportation to/from the pharmacy, and opioid withdrawal symptoms being the most common barriers. 87% reported they would not have started buprenorphine that same day if the mobile medical unit had not been present. Nearly half of survey participants reported having taken buprenorphine that was not prescribed to them. Qualitative analysis of open-ended survey responses noted the importance of convenient accessibility, comprehensive care, and a non-judgmental environment.
CONCLUSIONS: Mobile medical units that dispense buprenorphine are an innovative model to reach patients with OUD who have significant treatment access barriers. This study found that patients who experienced barriers to accessing buprenorphine from a pharmacy were highly satisfied with the mobile medical unit\'s buprenorphine dispensing process. Programs seeking to develop mobile buprenorphine dispensing programs should consider patient priorities of accessibility, comprehensive care, and welcoming, non-judgmental environments.
METHODS: All patients who were dispensed buprenorphine via the mobile medical unit were invited to participate in a 7-item anonymous survey between May 24, 2023, and August 25, 2023. The survey included 5-point satisfaction scale, multiple-choice, and open-ended questions. Outcomes included satisfaction with buprenorphine dispensing from the mobile medical unit, satisfaction with filling buprenorphine at a pharmacy in the past, barriers experienced at pharmacies when filling buprenorphine, and whether the client would have started treatment that day if the mobile medical unit had not been present. Satisfaction scale and multiple-choice question responses were assessed using descriptive statistics. Wilcoxon signed-rank test was used to compare median satisfaction levels between receiving buprenorphine from the mobile medical unit versus filling a buprenorphine prescription at a community pharmacy. Open-ended questions were analyzed qualitatively using inductive thematic analysis.
RESULTS: 106 unique patients were dispensed buprenorphine from the mobile unit during the study period. Of these patients, 54 (51%) completed the survey. Respondents reported high satisfaction with the buprenorphine dispensing process as a part of a mobile medical unit. Of those who had previously filled buprenorphine at a pharmacy, 83% reported at least one barrier, with delays in prescription dispensing from a community pharmacy, lack of transportation to/from the pharmacy, and opioid withdrawal symptoms being the most common barriers. 87% reported they would not have started buprenorphine that same day if the mobile medical unit had not been present. Nearly half of survey participants reported having taken buprenorphine that was not prescribed to them. Qualitative analysis of open-ended survey responses noted the importance of convenient accessibility, comprehensive care, and a non-judgmental environment.
CONCLUSIONS: Mobile medical units that dispense buprenorphine are an innovative model to reach patients with OUD who have significant treatment access barriers. This study found that patients who experienced barriers to accessing buprenorphine from a pharmacy were highly satisfied with the mobile medical unit\'s buprenorphine dispensing process. Programs seeking to develop mobile buprenorphine dispensing programs should consider patient priorities of accessibility, comprehensive care, and welcoming, non-judgmental environments.
摘要：
背景：在美国，过量死亡人数继续上升，尽管丁丙诺啡和美沙酮等有效治疗阿片类药物使用障碍（OUD）。已经开发了能够分配丁丙诺啡的移动医疗单位，以吸引患者并消除获得OUD治疗的障碍。这项研究报告了在芝加哥地区分配丁丙诺啡的移动医疗单位的患者的调查反应，IL具有高过量发生率。
方法：在2023年5月24日至2023年8月25日之间，邀请通过移动医疗单位分配丁丙诺啡的所有患者参加7项匿名调查。调查包括5分满意度量表，多项选择,和开放式问题。结果包括对流动医疗单位分配的丁丙诺啡的满意度，对过去在药房填充丁丙诺啡的满意度，在药店灌装丁丙诺啡时遇到的障碍，以及如果移动医疗单位不在场，客户是否会在当天开始治疗。使用描述性统计数据评估满意度量表和多项选择问题回答。Wilcoxon符号秩检验用于比较从移动医疗单位接受丁丙诺啡与在社区药房填写丁丙诺啡处方之间的中位满意度。开放式问题采用归纳主题分析法进行定性分析。
结果：在研究期间，106名独特的患者从移动单元分配丁丙诺啡。在这些病人中,54（51％）完成了调查。受访者对丁丙诺啡的分配过程非常满意，这是移动医疗单位的一部分。在那些以前在药房装满丁丙诺啡的人中，83%报告说至少有一个屏障，随着社区药房处方分配的延迟，缺乏往返药房的交通，阿片类药物戒断症状是最常见的障碍。87％的人报告说，如果没有移动医疗单位，他们将不会在同一天开始丁丙诺啡。近一半的调查参与者报告说服用了未给他们开处方的丁丙诺啡。对开放式调查答复的定性分析指出了方便可及性的重要性，全面护理，和非评判性的环境。
结论：分配丁丙诺啡的移动医疗单位是一种创新模式，可以帮助有明显治疗障碍的OUD患者。这项研究发现，从药房获得丁丙诺啡遇到障碍的患者对移动医疗单位的丁丙诺啡分配过程非常满意。寻求开发移动丁丙诺啡配药计划的计划应考虑患者可访问性的优先事项，全面护理，欢迎,非评判性环境。
方法：在2023年5月24日至2023年8月25日之间，邀请通过移动医疗单位分配丁丙诺啡的所有患者参加7项匿名调查。调查包括5分满意度量表，多项选择,和开放式问题。结果包括对流动医疗单位分配的丁丙诺啡的满意度，对过去在药房填充丁丙诺啡的满意度，在药店灌装丁丙诺啡时遇到的障碍，以及如果移动医疗单位不在场，客户是否会在当天开始治疗。使用描述性统计数据评估满意度量表和多项选择问题回答。Wilcoxon符号秩检验用于比较从移动医疗单位接受丁丙诺啡与在社区药房填写丁丙诺啡处方之间的中位满意度。开放式问题采用归纳主题分析法进行定性分析。
结果：在研究期间，106名独特的患者从移动单元分配丁丙诺啡。在这些病人中,54（51％）完成了调查。受访者对丁丙诺啡的分配过程非常满意，这是移动医疗单位的一部分。在那些以前在药房装满丁丙诺啡的人中，83%报告说至少有一个屏障，随着社区药房处方分配的延迟，缺乏往返药房的交通，阿片类药物戒断症状是最常见的障碍。87％的人报告说，如果没有移动医疗单位，他们将不会在同一天开始丁丙诺啡。近一半的调查参与者报告说服用了未给他们开处方的丁丙诺啡。对开放式调查答复的定性分析指出了方便可及性的重要性，全面护理，和非评判性的环境。
结论：分配丁丙诺啡的移动医疗单位是一种创新模式，可以帮助有明显治疗障碍的OUD患者。这项研究发现，从药房获得丁丙诺啡遇到障碍的患者对移动医疗单位的丁丙诺啡分配过程非常满意。寻求开发移动丁丙诺啡配药计划的计划应考虑患者可访问性的优先事项，全面护理，欢迎,非评判性环境。
