Zanjani Faika, Brooks Marshall, Waters Leland, Parsons Pamela, Slattum Patricia
Virginia Commonwealth University, Richmond, USA.
Gerontol Geriatr Med. 2020 Apr 4;6:2333721420908985. doi: 10.1177/2333721420908985. eCollection 2020 Jan-Dec.
Opioid harm reduction is increasingly important in the care of the older adults, who are at higher risk for negative opioid-related outcomes due to high prevalence of pain, multimorbidity, polypharmacy, and age-changes in metabolism. Our project aims to develop, implement, and evaluate an interprofessional opioid harm reduction service training. This evaluation occurs in context of the Richmond Health and Wellness Program (RHWP), a community-based interprofessional wellness care coordination equity initiative, within buildings designated for low-income and disabled older adults. The geriatric opioid harm reduction training was delivered online and inperson, and followed up with case-discussions and practice. Pre ( = 69)/post ( = 62) student assessments indicated that after the training, there was an increase in knowledge. At follow-up, 60% recognized tramadol as an opioid, 50% at baseline. About 97% correctly indicated that MME represents morphine milligram equivalent, 80% at baseline. About 93% indicated that 50 MME level greatly increases opioid overdose risk, 62% at baseline. Only 20%, change from 60% at baseline, reported not being able to calculate MME at post assessment. Findings indicate that geriatric opioid harm reduction training within community-based wellness care coordination is feasible. Future works need to explore the impact on student practice in clinical settings and resident health.
阿片类药物危害减少在老年人护理中日益重要，由于疼痛高发、多种疾病并存、多种药物联合使用以及新陈代谢的年龄变化，老年人出现与阿片类药物相关负面结果的风险更高。我们的项目旨在开发、实施和评估一项跨专业的阿片类药物危害减少服务培训。这项评估是在里士满健康与健康计划（RHWP）的背景下进行的，该计划是一项基于社区的跨专业健康护理协调公平倡议，在为低收入和残疾老年人指定的建筑内开展。老年阿片类药物危害减少培训通过线上和线下方式进行，并随后进行案例讨论和实践。（培训前n = 69/培训后n = 62）学生评估表明，培训后知识有所增加。在随访中，60%的人认识到曲马多是一种阿片类药物，基线时为50%。约97%的人正确指出MME代表吗啡毫克当量，基线时为80%。约93%的人表示50 MME水平会大大增加阿片类药物过量风险，基线时为62%。在评估后，只有20%（从基线时的60%变化而来）的人报告无法计算MME。研究结果表明，在基于社区的健康护理协调中开展老年阿片类药物危害减少培训是可行的。未来的工作需要探索其对临床环境中学生实践和居民健康的影响。
