BACKGROUND Medication-assisted treatment (MAT) is an evidence-based program for patients with opioid use disorders. Yet, within the state of Utah, MAT had not been widely available, promoted, or adopted within the public sector. Recognizing the potential benefit, a collective impact approach was used to promote social change and increase the use of MAT in the community for treatment of opioid use disorders. OBJECTIVE Conduct a retrospective, observational case series study to measure the effect of a community-based, collective impact approach implementing the MAT program to improve the rate of abstinence and retention among individuals identified with an opioid use disorder in three Utah counties. METHODS The study was designed and implemented by the Utah Opioid Community Collaborative (OCC) using a collective impact approach, which included broad sector coordination (public-private collaboration), a common agenda, participation in mutually reinforcing activities, continuous communication, consistent measurement of results, and identification of a backbone organization. The MAT intervention program includes use of medications approved by the U.S. Food and Drug Administration in combination with counseling and behavioral therapies delivered within two community sites. Analysis was performed over time to describe the rate of abstinence and retention associated with participation in the MAT program during 2015 through 2017. RESULTS Of the 339 identified with risk of an opioid use disorders, 228 enrolled in the MAT Program. At MAT enrollment, average age was 32.6 ± 8.2 years old and 58.0% were female. At 365 days after MAT enrollment, 84% of participants were abstinent from opioid substances and 62% from all illicit substances. CONCLUSIONS Use of a collective impact approach provides a successful mobilization framework in Utah for increasing community engagement and expanding patient access to underresourced MAT programs while suggesting a high rate of abstinence from illicit substances at 12 months.

中文翻译：

---

与阿片类药物使用障碍患者的药物辅助治疗计划相关的禁欲和保留趋势。

背景技术药物辅助治疗（MAT）是针对阿片类药物使用障碍的患者的基于证据的程序。但是，在犹他州内，MAT在公共部门尚未得到广泛使用，推广或采用。认识到潜在的好处，因此采用了一种集体影响的方法来促进社会变革，并在社区中使用MAT来治疗阿片类药物使用障碍。目的进行一项回顾性观察性病例系列研究，以评估实施MAT计划的社区集体影响方法的效果，以提高犹他州三个县确定为阿片类药物使用障碍的个体的禁欲和保留率。方法该研究是由犹他州阿片类药物社区合作组织（OCC）使用集体影响方法设计和实施的，其中包括广泛的部门协调（公私合作），共同的议程，参与相辅相成的活动，持续的沟通，对结果的一致衡量以及确定骨干组织。MAT干预计划包括使用美国食品和药物管理局批准的药物，以及在两个社区地点提供的咨询和行为疗法。随时间推移进行了分析，以描述2015年至2017年期间与参加MAT计划相关的戒酒和保留率。结果在339名被确认存在阿片类药物使用风险的人中，有228名参加了MAT计划。在参加MAT时，平均年龄为32.6±8.2岁，女性为58.0％。参加MAT后365天，84％的参与者戒断了阿片类物质，而62％的参与者戒除了所有非法物质。结论使用集体影响方法在犹他州提供了一个成功的动员框架，可提高社区参与度并扩大患者获得资源贫乏的MAT计划的机会，同时建议在12个月内戒除非法药物的比率很高。