Department of Pharmacy, VA St. Louis Health Care System, St. Louis, Missouri, USA.
Department of Pharmacy Practice, St. Louis College of Pharmacy, St. Louis, Missouri, USA.
Subst Abus. 2021;42(4):625-629. doi: 10.1080/08897077.2020.1809606. Epub 2020 Sep 3.
Limited data describes the effectiveness of strategies to optimize naloxone rescue kit distribution. Mental health clinical pharmacy specialists (CPS) at VA St. Louis HCS aimed to increase distribution of naloxone rescue kits to patients with Opioid Use Disorder (OUD). An informational letter detailing the purpose of rescue kits and how to obtain one were sent to patients with OUD who had no active order for a naloxone rescue kit within the previous year. Roughly half of these patients were targeted for follow-up education via telephone. : A retrospective study was conducted comparing the effectiveness of these contact methods. Study groups included those contacted by letter alone and those contacted by both letter and phone call. The primary outcome was order placement for a rescue kit within 90 days of contact. Post-hoc analysis included a multivariate regression, case-control evaluation of variables potentially associated with kit distribution. : In total, 335 patients were included. Of 185 patients targeted for phone follow-up, 81 were reached (43.8%), and 254 received the letter alone. The primary outcome was achieved by 13 (5.1%) and 52 (64.2%) participants in the letter alone and letter plus phone contact groups, respectively ( < 0.001). In multivariate analysis, phone contact (OR 38.6; 95% CI 17.5-85.0), nonwhite race (OR 3.4; 95% CI 1.5-7.6), prior participation in the substance abuse rehabilitation treatment program (OR 3.2; 95% CI 1.3-8.0), and current active opioid prescription (OR 3.7; 95% CI 1.3-10.2) were independently associated with an order for a naloxone rescue kit. : In patients with OUD, those contacted by phone in addition to receiving a letter were significantly more likely to receive a naloxone kit than those contacted via letter alone. In addition to contact by phone, nonwhite race, prior participation in rehabilitation and active opioid prescription were associated with a higher rate of kit obtainment.
关于优化纳洛酮急救包分发策略的有效性数据有限。VA 圣路易斯 HCS 的精神健康临床药剂师 (CPS) 旨在增加向患有阿片类药物使用障碍 (OUD) 的患者分发纳洛酮急救包。向过去一年中没有纳洛酮急救包有效订单的 OUD 患者发送了一封详细说明急救包用途和获取方式的信息函。大约一半的患者被确定通过电话接受后续教育。进行了一项回顾性研究，比较了这些联系方式的有效性。研究组包括仅通过信函联系的组和通过信函和电话联系的组。主要结果是在接触后 90 天内下达急救包订单。事后分析包括对与套件分发相关的潜在变量进行多元回归、病例对照评估。共纳入 335 名患者。在 185 名需要电话随访的患者中，有 81 名患者（43.8%）被联系上，而 254 名患者仅收到了信函。仅通过信函组和信函加电话联系组分别有 13 名（5.1%）和 52 名（64.2%）参与者达到主要结局（ < 0.001）。在多变量分析中，电话联系（OR 38.6；95%CI 17.5-85.0）、非白人种族（OR 3.4；95%CI 1.5-7.6）、既往参加药物滥用康复治疗计划（OR 3.2；95%CI 1.3-8.0）和当前阿片类药物处方（OR 3.7；95%CI 1.3-10.2）与纳洛酮急救包的订购独立相关。在患有 OUD 的患者中，与仅通过信函联系的患者相比，通过电话联系并收到信函的患者更有可能收到纳洛酮急救包。除电话联系外，非白人种族、既往参加康复治疗和阿片类药物处方活跃与获得急救包的比率较高相关。
