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首页> 外文期刊>Substance Abuse Treatment, Prevention, and Policy >The impact of COVID-19 on healthcare delivery for people who use opioids: a scoping review
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The impact of COVID-19 on healthcare delivery for people who use opioids: a scoping review

机译：Covid-19对使用阿片类药物的人的医疗送货的影响：范围审查

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The COVID-19 pandemic disrupted healthcare delivery worldwide with likely negative effects on people who use opioids (PWUO). This scoping review of the original research literature describes the impact of the COVID-19 pandemic on healthcare delivery for PWUO and identifies gaps in the literature. This scoping review of the original research literature maps the available knowledge regarding the impact of the COVID-19 pandemic on healthcare delivery for PWUO. We utilized the methodology developed by the Joanna Briggs Institute for scoping reviews, and content analyses methodology to characterize the current state of the literature. Of the 14 included studies, administrative database (n?=?11), cross-sectional (n?=?1) or qualitative (n?=?2) studies demonstrated service gaps (n?=?7), patient/provider experiences (n?=?3), and patient outcomes for PWUO (n?=?4). In March 2020, healthcare utilization dropped quickly, sharply increasing only for reasons of opioid overdose by May 2020. Service gaps existed in accessing treatment for new patients during the pandemic due to capacity and infrastructure limits. Physicians reported difficulty referring patients to begin an outpatient opioid treatment program due to increased restrictions in capacity and infrastructure. Patients also reported uncertainty about accessing outpatient treatment, but that telehealth initiation of buprenorphine increased access to treatment from home. Disproportionate increases in overdose rates among African Americans were reported in two studies, with differences by race and gender not examined in most studies. Fatal overdoses increased 60% in African Americans during the pandemic, while fatal overdoses in Non-Hispanic White individuals decreased. In summary, this beginning evidence demonstrates that despite early reluctance to use the healthcare system, opioid overdose-related use of healthcare increased throughout the pandemic. Service delivery for medications to treat OUD remained at or above pre-pandemic levels, indicating the ability of telehealth to meet demand. Yet, racial disparities that existed pre-pandemic for PWUO are intensifying, and targeted intervention for high-risk groups is warranted to prevent further mortality. As the pandemic progresses, future research must focus on identifying and supporting subgroups of PWUO who are at heightened risk for experiencing negative outcomes and lack of access to care.
机译：Covid-19大流行中断了全球医疗保健交付，可能对使用阿片类药物（PWUO）的人的负面影响。该研究文献的这个范围审查描述了Covid-19大流行对PWUO的医疗保健交付的影响，并确定了文学中的差距。该范围审查原始研究文献地图地图有关Covid-19流行对PWUO医疗送货的影响的可用知识。我们利用了乔安娜布里格斯研究院审查，内容分析方法所开发的方法，以表征文献的当前状态。其中14项研究，行政数据库（n？=？11），横截面（n？=？1）或定性（n？=？2）研究证明了服务空白（n？=？7），患者/提供者经验（n？=？3），pwuo的患者结果（n？=？4）。在2020年3月，医疗保健利用率迅速下降，仅出于阿片类药物过量的原因在2020年5月的原因急剧增加。由于能力和基础设施限制，在流行病中访问新患者的治疗方面存在服务差距。由于能力和基础设施的限制增加，医生报告难以提及患者开始门诊阿片类药物治疗计划。患者还报告了对门诊治疗的不确定性，但远程治疗Buprenorphine增加了从家庭治疗的获取。两项研究报告了非洲裔美国人在非洲裔美国人过量率的增加的增加，在大多数研究中没有检查种族和性别的差异。在大流行期间，非洲裔美国人的致命产量增加了60％，而非西班牙裔白人致命的过度造成的致命过量。总之，这一开始证据表明，尽管早期不愿利用医疗保健系统，但在整个大流行中都会增加与医疗相关的医疗保健使用。治疗oud的药物的服务递送留在或高于大流行前水平，表明遥气健康能够满足需求的能力。然而，存在对PWUO预先发生的种族差异正在加剧，并且有针对性化的高风险群体干预被认为是防止进一步的死亡率。随着大流行的进展，未来的研究必须侧重于识别和支持普鲁奥的子群，他们正在提高经历负面成果和缺乏护理机会的风险。

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