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1.
J Subst Use Addict Treat ; 160: 209310, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38331319

RESUMO

BACKGROUND: Medications for Opioid Use Disorder (MOUD) are an effective method to treat persons with opioid use disorder (OUD). Longer treatment times are associated with better health outcomes, yet treatment retention rates remain low. This study aimed to assess patient characteristics and experiences associated with retention in treatment. METHODS: Data were from an observational cohort study of OUD treatments. Among persons receiving buprenorphine or methadone, log-binomial regression models assessed the relationship between patient characteristics and experiences and three retention outcomes: retention in any OUD treatment, retention in the index treatment (OUD treatment being administered at the time when patients were screened for study eligibility), and 6-month retention in the index treatment. RESULTS: Individuals being treated with methadone at the start of the study compared to those treated with buprenorphine were more likely to remain in their same index treatment at the 18-month follow-up (aPR = 1.35; 95 % CI = 1.11-1.65), and to have remained on their index treatment for 6-months or longer (aPR = 1.22; 95 % CI = 1.14-1.32), but were not significantly more likely to remain in any OUD treatment overall. Individuals residing five miles or less from treatment were more likely to have been retained in any OUD treatment (aPR = 1.06; 95 % CI = 1.00-1.12), to remain in their index treatment at the 18-month follow-up (aPR = 1.21; 95 % CI = 1.08-1.36), and to have remained in their index treatment for 6 months or more (aPR = 1.08; 95 % CI = 1.02-1.13). Individuals without health insurance were less likely to be retained in any OUD treatment (aPR = 0.86; 95 % CI = 0.78-0.95). CONCLUSION: The prevalence of retention in any OUD treatment was higher for individuals residing five miles or less from treatment. These findings expand on previous studies that have shown distance to and location of treatment sites can impact treatment access and retention. Lack of health insurance was also associated with lower retention in any OUD treatment in this study. Given the high burden associated with overdose deaths, it is important to understand and address barriers to retention in treatment.


Assuntos
Buprenorfina , Metadona , Tratamento de Substituição de Opiáceos , Transtornos Relacionados ao Uso de Opioides , Humanos , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Buprenorfina/uso terapêutico , Feminino , Masculino , Tratamento de Substituição de Opiáceos/métodos , Metadona/uso terapêutico , Adulto , Pessoa de Meia-Idade , Estudos de Coortes , Adesão à Medicação/estatística & dados numéricos , Analgésicos Opioides/uso terapêutico , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos
2.
J Public Health Manag Pract ; 28(Suppl 6): S355-S358, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36194806

RESUMO

The Martinsburg Initiative (TMI) is a community-based model developed in Martinsburg, West Virginia, that implements a comprehensive approach to adverse childhood experiences and substance use prevention and mitigation by leveraging partnerships in public health and health care, public safety, and education. TMI receives coordinated federal funding and technical assistance from the Centers for Disease Control and Prevention, the Washington-Baltimore High Intensity Drug Trafficking Agency, and the National Association of County and City Health Officials to integrate evidence-based and promising strategies. It advances such strategies by translating them for implementation within the community, evaluating the reach and potential impact of the model, and by engaging key stakeholders. Preliminary results describing program reach and short-term outcomes collected for a subset of the interventions during implementation are presented. The model uses touchpoints across multiple community sectors in the city of Martinsburg to break the cycle of trauma and substance use across the life span.


Assuntos
Saúde Pública , Transtornos Relacionados ao Uso de Substâncias , Centers for Disease Control and Prevention, U.S. , Atenção à Saúde/métodos , Humanos , Instituições Acadêmicas , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Estados Unidos
3.
Emerg Infect Dis ; 25(12): 2264-2265, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31742511

RESUMO

We assessed IgM detection in Zika patients from the 2016 outbreak in Miami-Dade County, Florida, USA. Of those with positive or equivocal IgM after 12-19 months, 87% (26/30) had IgM 6 months later. In a survival analysis, ≈76% had IgM at 25 months. Zika virus IgM persists for years, complicating serologic diagnosis.


Assuntos
Anticorpos Antivirais/imunologia , Imunoglobulina M/imunologia , Infecção por Zika virus/epidemiologia , Infecção por Zika virus/imunologia , Zika virus/imunologia , Adulto , Idoso , Anticorpos Antivirais/sangue , Surtos de Doenças , Feminino , Florida/epidemiologia , Humanos , Imunoglobulina M/sangue , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Adulto Jovem , Zika virus/genética , Infecção por Zika virus/diagnóstico , Infecção por Zika virus/virologia
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