Developing evidence-based practice guidelines for delivering and monitoring youth-centred opioid agonist treatment
Notice bibliographique
Résumé
Background: Opioid use disorder (OUD) is a chronic health condition that impacts over 26 million people worldwide and is one of the largest contributor of global disease burden (e.g., blood-borne infections, unintentional injuries, overdose deaths, suicide). Opioid agonist treatment (OAT) is widely recognized as the safest and most effective treatment for people with OUD. Yet, youth encounter substantial structural barriers to engage with OAT (e.g., age-based eligibility criteria, misinformation, and stigma). Further, youths’ treatment goals, preferences, and needs often do not align with how OAT is currently delivered (e.g., daily dispensation). Thus, this life-saving treatment remains underutilized among youth, further exacerbating opioid-related harms (e.g., mental and physical morbidity, social exclusion, mortality) in North America and many nations globally. Objective: This project aims to develop evidence-based practice guidelines for the delivery and monitoring of youth-centred OAT. These guidelines will help service providers deliver OAT and measure outcomes that are relevant and informed by youth. Methods: In the first phase of this study (completed), we conducted a scoping review to identify and summarize peer-reviewed literature published between 2015 and 2023 on the full range of evidence-based interventions and health-related services for youth (ages 12-25) who use unregulated opioids in North America. In the second phase (December 2023 – January 2024), we will conduct semi-structured interviews with four expert groups (youth, caregivers, service providers, and policy makers) who have experience receiving, delivering, or making decisions on the implementation and monitoring of OAT for youth. Interviews will collect data on their perspectives of the optimal principles, characteristics, settings, and outcomes of a youth-centred OAT model of care, as well as their recommendations for implementing a best practice across diverse healthcare settings. The interviews will be audio-recorded, transcribed, and analyzed using a directed content analysis approach. We will share the findings from the analysis at the conference and use them to inform the implementation of youth-centred OAT across Foundry, a network of integrated youth services in British Columbia. Results/Implications: Twenty-five articles were included in the scoping review. The findings show that OAT leads to improved substance use outcomes among youth, however treatment effects were not as strong as in adults. Few studies in the scoping review were conducted in healthcare settings that were tailored to youth or in integrated care settings where youth could engage with comprehensive and individualized care. The results of the review support the need for developing youth-centred OAT practice guidelines. The practice guidelines will improve the quality and monitoring of OAT for youth, and thus, reduce the adverse harms associated with opioid use. While these guidelines will be developed from the perspective of experts in British Columbia, they can provide direction for pan-Canadian and international guidelines.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,263 | 0,504 |
| Méta-épidémiologie (sens strict) | 0,004 | 0,003 |
| Méta-épidémiologie (sens large) | 0,007 | 0,012 |
| Bibliométrie | 0,026 | 0,018 |
| Études des sciences et des technologies | 0,005 | 0,004 |
| Communication savante | 0,014 | 0,015 |
| Science ouverte | 0,018 | 0,014 |
| Intégrité de la recherche | 0,015 | 0,012 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,008 | 0,005 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».