Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, United States.
Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, United States.
Addict Behav. 2018 Nov;86:56-60. doi: 10.1016/j.addbeh.2018.03.011. Epub 2018 Mar 28.
Opioid-related overdose has increased 137% in the past decade. Training nonmedical bystanders to administer naloxone (Narcan™) is a widely-researched intervention that has been associated with decreases in overdose rates in the communities in which it has been implemented. A recent review advocated for noninjectable formulations of naloxone, however patient preference for naloxone formulations has not yet been examined (Strang et al., 2016).
Two cohorts of respondents (N = 501, N = 172) who reported currently being prescribed an opioid for pain management were recruited through the crowd-sourcing program Amazon Mechanical Turk (MTurk) to assess their preference for naloxone formulations. All respondents were provided a description of different formulations and asked to indicate all formulations they would be willing to administer for overdose reversal and to then rank formulations in order of preference.
Results were remarkably similar across both cohorts. Specifically, respondents preferred noninjectable formulations (intranasal, sublingual, buccal) over injectable (intravenous, intramuscular) formulations. A small percent (8.9%-9.8%) said they would never be willing to administer naloxone. An identical percent of respondents in both cohorts (44.9%) rated intranasal as their most preferred formulation.
Two independent cohorts of respondents who were receiving opioid medications for pain management reported a preference for noninjectable over injectable formulations of naloxone to reverse an opioid overdose. Though initial preference is only one of many factors that impacts ultimate public acceptance and uptake of a new product, these results support the additional research and development of noninjectable naloxone formulations.
在过去十年中，阿片类药物相关的过量用药增加了 137%。培训非医疗急救人员使用纳洛酮（Narcan™）是一项广泛研究的干预措施，它与实施地区的过量用药率下降有关。最近的一项审查主张使用非注射用纳洛酮制剂，但尚未检查患者对纳洛酮制剂的偏好（Strang 等人，2016 年）。
通过众包程序 Amazon Mechanical Turk（MTurk）招募了两个报告目前正在服用阿片类药物治疗疼痛的受访者队列（N=501，N=172），以评估他们对纳洛酮制剂的偏好。向所有受访者提供不同制剂的描述，并要求他们指出愿意用于逆转过量用药的所有制剂，然后按偏好顺序对制剂进行排名。
两个队列的结果非常相似。具体来说，受访者更喜欢非注射制剂（鼻内、舌下、颊部）而不是注射制剂（静脉、肌肉）。一小部分（8.9%-9.8%）的受访者表示他们永远不会愿意使用纳洛酮。两个队列中相同比例（44.9%）的受访者将鼻内制剂评为他们最首选的制剂。
两个接受阿片类药物治疗疼痛的独立受访者队列报告说，他们更喜欢非注射用纳洛酮制剂而不是注射用纳洛酮制剂来逆转阿片类药物过量。尽管初始偏好只是影响新产品最终公众接受和采用的众多因素之一，但这些结果支持进一步研究和开发非注射用纳洛酮制剂。
