Leece Pamela, Orkin Aaron, Shahin Rita, Steele Leah S
Resident in the Public Health and Preventive Medicine Program at the Dalla Lana School of Public Health at the University of Toronto in Ontario.
Clinical Public Health Fellow at the Dalla Lana School of Public Health at the University of Toronto.
Can Fam Physician. 2015 Jun;61(6):538-543.
To explore family physicians' attitudes toward prescribing naloxone to at-risk opioid users, as well as to determine the opportunities and challenges for expanding naloxone access to patients in family practice settings.
One-hour focus group session and SWOT (strengths, weaknesses, opportunities, and threats) analysis.
Workshop held at the 2012 Family Medicine Forum in Toronto, Ont.
Seventeen conference attendees from 3 Canadian cities who practised in various family practice settings and who agreed to participate in the workshop.
The workshop included an overview of information about naloxone distribution and overdose education programs, followed by group discussion in smaller focus groups. Participants were instructed to focus their discussion on the question, "Could this [overdose education and naloxone prescription] work in your practice?" and to record notes using a standardized discussion guide based on a SWOT analysis. Two investigators reviewed the forms, extracting themes using an open coding process.
Some participants believed that naloxone could be used safely among family practice patients, that the intervention fit well with their clinical practice settings, and that its use in family practice could enhance engagement with at-risk individuals and create an opportunity to educate patients, providers, and the public about overdose. Participants also indicated that the current guidelines and support systems for prescribing or administering naloxone were inadequate, that medicolegal uncertainties existed for those who prescribed or administered naloxone, and that high-quality evidence about the intervention's effectiveness in family practice was lacking.
Family physicians believe that overdose education and naloxone prescription might provide patients at risk of opioid overdose in their practices with broad access to a potentially lifesaving intervention. However, they explain that there are key barriers currently limiting widespread implementation of naloxone use in family practice settings.
探讨家庭医生对向有阿片类药物使用风险的患者开具纳洛酮的态度，并确定在家庭医疗环境中扩大患者获取纳洛酮机会的机遇与挑战。
为期一小时的焦点小组会议及SWOT（优势、劣势、机遇和威胁）分析。
在安大略省多伦多市举行的2012年家庭医学论坛上举办的研讨会。
来自加拿大3个城市的17名会议参会者，他们在不同的家庭医疗环境中执业，并同意参加此次研讨会。
研讨会包括对纳洛酮分发和过量用药教育项目信息的概述，随后在较小的焦点小组中进行小组讨论。参与者被要求将讨论重点放在“这[过量用药教育和纳洛酮处方]在你的执业中可行吗？”这个问题上，并使用基于SWOT分析的标准化讨论指南记录笔记。两名研究人员审查这些表格，通过开放编码过程提取主题。
一些参与者认为纳洛酮可在家庭医疗患者中安全使用，该干预措施与他们的临床执业环境契合良好，且在家庭医疗中使用纳洛酮可增强与有风险个体的互动，并为教育患者、医疗服务提供者和公众有关过量用药创造机会。参与者还指出，目前关于开具或使用纳洛酮的指南和支持系统不足，开具或使用纳洛酮的人员存在法医学上的不确定性，且缺乏关于该干预措施在家庭医疗中有效性的高质量证据。
家庭医生认为，过量用药教育和纳洛酮处方可能为其执业中面临阿片类药物过量风险的患者提供广泛获取一种可能挽救生命的干预措施的机会。然而，他们解释说，目前存在关键障碍限制了纳洛酮在家庭医疗环境中的广泛应用。
