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2019 年对犹他州农村县阿片类药物使用障碍治疗资源的评估。

A 2019 evaluation of opioid use disorder treatment resources in rural Utah counties.

出版信息

J Am Pharm Assoc (2003). 2021 Sep-Oct;61(5):513-521. doi: 10.1016/j.japh.2021.03.019. Epub 2021 Mar 31.

Abstract

OBJECTIVES

The opioid crisis significantly affects residents of rural communities who already experience poor health outcomes based on social determinants. Therefore, this project evaluated the reported availability and accessibility of opioid use disorder (OUD) treatment resources in rural Utah county pharmacies through a multistep process intended to estimate the distance (miles) to registered (waivered) OUD care providers and community pharmacies and, thus, the ability to fill prescriptions for OUD treatment medications.

METHODS

First, the United States Department of Agriculture Economic Research Service dichotomous classification scheme was used to identify nonmetropolitan counties. Second, online resources were used to identify the volume of waivered treatment providers and community pharmacies by county. Third, the driving distances to both resources were estimated according to ZIP Code and county. Finally, the immediate availability of filling a prescription for OUD treatment medications was determined by surveying community pharmacists in rural Utah counties.

RESULTS

Nineteen of the 29 Utah counties were identified as rural and included in the study. Pharmacists in 50 of the 75 viable pharmacies completed surveys (66.7% usable response rate). OUD treatment medications were immediately available for dispensing in 90% (45 of 50) of the responding pharmacies. Two of the 19 counties (10.5%) lacked a pharmacy, and 6 of the 19 counties (31.6%) lacked a registered OUD treatment provider. Driving distances ranged from 1 mile to 71 miles to the nearest pharmacy and from 1 mile to 96 miles to the nearest waivered treatment provider.

CONCLUSION

OUD treatment medications were readily available in some but not all rural Utah pharmacies. However, geographic barriers may prevent reasonable access to treatment providers and pharmacies for residents of smaller, remote communities.

摘要

目的

阿片类药物危机严重影响了农村社区的居民,这些居民已经受到社会决定因素导致的不良健康结果的影响。因此,本项目通过多步骤过程评估了犹他县农村药店报告的阿片类药物使用障碍(OUD)治疗资源的可及性和可及性,旨在估计到注册(豁免)OUD 护理提供者和社区药店的距离(英里),从而确定是否有能力开处 OUD 治疗药物的处方。

方法

首先,使用美国农业部经济研究局的二分法分类方案来确定非大都市县。其次,使用在线资源按县识别有多少豁免治疗提供者和社区药店。第三,根据邮政编码和县城估算到达这两种资源的驾驶距离。最后,通过对犹他州农村社区的药剂师进行调查来确定立即开处 OUD 治疗药物处方的能力。

结果

在 29 个犹他州县中,有 19 个被确定为农村地区,并纳入了研究。在 75 家可行药店中的 50 家药店的药剂师完成了调查(66.7%的可用响应率)。在 50 家做出回应的药店中有 90%(45 家)可以立即配药 OUD 治疗药物。19 个县中有 2 个(10.5%)没有药店,19 个县中有 6 个(31.6%)没有注册的 OUD 治疗提供者。到最近的药店的驾驶距离从 1 英里到 71 英里不等,到最近的豁免治疗提供者的距离从 1 英里到 96 英里不等。

结论

OUD 治疗药物在一些但不是所有犹他州农村药店都很容易获得。然而,对于较小、偏远社区的居民来说,地理障碍可能会妨碍他们合理获得治疗提供者和药店。

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