Buffington Daniel E, Lozicki Alyson, Alfieri Thomas, Bond T Christopher
University of South Florida, College of Medicine.
University of South Florida, College of Pharmacy, Tampa, FL 33617, USA.
J Pain Res. 2019 Feb 19;12:725-732. doi: 10.2147/JPR.S171742. eCollection 2019.
Drivers of excess controlled substance disposal behaviors are not well understood. A survey of patients who had received opioid-based medications was conducted to inform the design of future innovative drug take-back programs.
This was a cross-sectional survey study conducted in 152 participants who received treatment with an opioid within the previous 2 years and had possession of unused medication following either switching to a different opioid or discontinuation of pain.
Approximately one-third of patients had disposed of their unused opioid medication. Education about the importance of and appropriate methods for drug disposal was associated with a significantly increased likelihood of patients disposing of unused medication, and it was observed that patients prescribed an immediate-release/short-acting opioid were twice as likely to keep their medication compared to those prescribed an extended-release/long-acting opioid. The most commonly reported methods for disposal were via drug return kiosks and flushing the medication down the toilet. Some of the most impactful drivers of unused opioid disposal were routine practice of disposing of all unused drugs and instruction from a health care provider, and the most common driver of keeping unused medication was the desire to have it on-hand should there be a need to treat pain in the future. Over 80 % of patients indicated that they would be more likely to use a drug take-back service if they were offered compensation or if the kiosk was in a location that they visited frequently, and approximately half of the patients indicated that they would be willing to request an initial partial fill of an opioid prescription to reduce the volume of unused medication.
There is a clear need to increase patient awareness about the importance and methods of proper medication disposal, and a great opportunity for health care providers to increase patient education efforts. These study findings also highlight key areas for improvement in drug take-back programs that may promote and incentivize more patients to utilize the services.
人们对过量管制药物处置行为的驱动因素了解不足。对接受过阿片类药物治疗的患者进行了一项调查，以指导未来创新药物回收项目的设计。
这是一项横断面调查研究，共纳入152名参与者，他们在过去2年内接受过阿片类药物治疗，且在改用其他阿片类药物或停止疼痛治疗后仍持有未使用的药物。
约三分之一的患者处置了未使用的阿片类药物。关于药物处置的重要性和适当方法的教育与患者处置未使用药物的可能性显著增加相关，并且观察到，与开具缓释/长效阿片类药物的患者相比，开具速释/短效阿片类药物的患者保留药物的可能性是其两倍。最常报告的处置方法是通过药物回收亭和将药物冲进马桶。未使用阿片类药物处置的一些最具影响力的驱动因素是处置所有未使用药物的常规做法和医疗保健提供者的指示，而保留未使用药物的最常见驱动因素是希望在未来需要治疗疼痛时手头有药。超过80%的患者表示，如果提供补偿或回收亭位于他们经常光顾的地点，他们更有可能使用药物回收服务，约一半的患者表示他们愿意要求初始部分填充阿片类药物处方以减少未使用药物的数量。
显然需要提高患者对正确药物处置的重要性和方法的认识，医疗保健提供者有很大机会加强患者教育工作。这些研究结果还突出了药物回收项目中可能促进和激励更多患者使用这些服务的关键改进领域。
