Hurt Brenten R, Hussain Atizaz, Aledhaim Ali, Moayedi Siamak, Schenkel Stephen M, Kim Hong K
University of Maryland School of Medicine, Baltimore, MD, USA.
Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
Subst Use Misuse. 2020;55(13):2237-2242. doi: 10.1080/10826084.2020.1797811. Epub 2020 Jul 30.
The opioid epidemic has prompted the expansion of take-home naloxone (THN) distribution programs. The proportion of emergency department (ED) patients with opioid misuse who have access to a naloxone kit (NK) and barriers to using it are unclear. Characterizing the access and barrier to NK use among at-risk ED patients. We enrolled a convenience sample of ED patients with active opioid misuse from May 21-July 31, 2018. We administered a survey to collect patients' demographic data, substance use history, and access to and use of NK. The primary outcome was NK access (prior receipt of a kit or prescription); secondary outcomes were knowledge and use of NK, and barriers to obtaining and using it. Of 165 respondents, 71.5% knew of THN programs and 57.6% (=95) had access to THN by either having received a NK (=90) or a prescription (=5); 34 respondents received both. Among 39 (23.6%) who received a naloxone prescription, 25 (64.1%) filled it. 60.0% (=99) reported knowing how to administer naloxone; lack of training was the primary reason (=63/66, 96.9%) for their unfamiliarity. Patients who presented after an opioid overdose (25.5%; =42) were less likely to have knowledge of THN programs (57.1% vs. 76.4%), and to have received a NK (35.7% vs. 61.0%). Awareness of THN programs was high among our cohort. But approximately 60% the respondents received a NK or knew how to use it. Despite efforts to expand THN access, gaps in knowledge, access, and use exist.
阿片类药物流行促使了居家使用纳洛酮（THN）分发项目的扩展。急诊科（ED）中存在阿片类药物滥用问题的患者能够获得纳洛酮试剂盒（NK）的比例以及使用该试剂盒的障碍尚不清楚。本研究旨在描述有风险的急诊科患者获取纳洛酮试剂盒的情况及使用障碍。我们选取了2018年5月21日至7月31日期间急诊科中有阿片类药物滥用行为的患者作为便利样本。我们进行了一项调查，以收集患者的人口统计学数据、物质使用史以及获取和使用纳洛酮试剂盒的情况。主要结局是获取纳洛酮试剂盒（之前收到过试剂盒或处方）；次要结局是对纳洛酮试剂盒的知晓和使用情况，以及获取和使用该试剂盒的障碍。在165名受访者中，71.5%知晓THN项目，57.6%（=95人）通过收到纳洛酮试剂盒（=90人）或处方（=5人）获得了THN；34名受访者两者都有。在39名（23.6%）收到纳洛酮处方的患者中，25名（64.1%）取了药。60.0%（=99人）报告知道如何使用纳洛酮；缺乏培训是他们不熟悉使用方法的主要原因（=63/66，96.9%）。在阿片类药物过量服用后前来就诊的患者（25.5%；=42人）知晓THN项目的可能性较小（57.1%对76.4%），且获得纳洛酮试剂盒的可能性也较小（35.7%对61.0%）。我们研究队列中对THN项目的知晓度较高。但约60%的受访者收到过纳洛酮试剂盒或知道如何使用它。尽管努力扩大THN的获取途径，但在知识、获取和使用方面仍存在差距。
