Carilion Clinic Institute for Orthopaedics and Neuroscience (Dr Miller), Virginia Tech Carilion School of Medicine (Mr Bouzaher), Roanoke, Virginia (Dr Miller).
J Public Health Manag Pract. 2020 May/Jun;26(3):259-269. doi: 10.1097/PHH.0000000000001153.
Southwestern Virginia demonstrates the highest regional mortality rate from prescription opioid overdoses. Nationally, 65% of patients misusing opioid medications received them from friends and family, underscoring the need for effective disposal of unused narcotics.
(1) To understand patient, provider, and medical student beliefs and misconceptions regarding proper methods of opioid disposal; (2) to characterize discrepancies that exist between patient self-reported habits and medical student/provider perceptions of opioid usage, disposal, and diversion.
Descriptive, cross-sectional, observational study.
Large, nonprofit health care organization and allopathic medical school in Southwestern Virginia.
All ambulatory patients 18 years or older presenting for elective consultation at health system orthopedics department; all institutionally employed physicians with active system e-mail addresses; and all current students at the associated medical school.
MAIN OUTCOMES/MEASURES: Patients: The number who had received information regarding proper methods of opioid disposal, intended disposal method, methods of disposal considered appropriate, comfort level with opioid disposal, and demographic data. Physicians and Medical Students: The number who had received instruction regarding proper methods of opioid disposal, acceptable means of opioid disposal, most appropriate disposal method, disposal method most likely to be employed by patients, practice profile/prescribing data, and medical school year.
In total, 64% of patients (n = 255/750) had never received instruction from a physician regarding opioid disposal; 56% of physicians (n = 212/732) and 78% (n = 80/171) of medical students indicated that they never received formal instruction regarding methods of disposal. The majority of physicians believed that their patients are most likely to use in-home methods of disposal or store prescription medications for future use; 61% of patients indicated a preference for accessible disposal facilities.
The discrepancy between patient and physician responses highlights a lack of communication regarding disposal of unused opioid medications and is a target for future intervention.
弗吉尼亚州西南部的处方类阿片类药物过量死亡率为全美最高。全美 65%的药物滥用患者从朋友和家人那里获得阿片类药物，这突显了有效处理未使用的麻醉性镇痛药的必要性。
（1）了解患者、医护人员和医学生对正确处理阿片类药物方法的信念和误解；（2）描述患者自我报告的阿片类药物使用、处理和滥用习惯与医护人员/医学生认知之间存在的差异。
描述性、横断面、观察性研究。
弗吉尼亚州西南部的一家大型非营利性医疗保健机构和一所全医学科医学院。
所有 18 岁及以上在医疗系统骨科就诊的门诊患者；所有有系统电子邮件地址的在职医生；以及相关医学院的所有在校学生。
主要结果/测量指标：患者：收到关于正确处理阿片类药物方法的信息、打算的处理方法、认为合适的处理方法、处理阿片类药物的舒适度以及人口统计学数据的人数。医生和医学生：收到有关阿片类药物正确处理方法、可接受的阿片类药物处理方法、最合适的处理方法、患者最有可能采用的处理方法、实践概况/处方数据和医学生年级的人数。
共有 64%的患者（n = 255/750）从未接受过医生关于阿片类药物处理的指导；56%的医生（n = 212/732）和 78%（n = 80/171）的医学生表示他们从未接受过关于处理方法的正式指导。大多数医生认为他们的患者最有可能在家中处理或储存处方药物以备将来使用；61%的患者表示倾向于使用易于处理的设施。
患者和医生的回答之间存在差异，表明在处理未使用的阿片类药物方面缺乏沟通，这是未来干预的重点。
