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患者对处方药物监测计划的体验:来自澳大利亚药品咨询热线的定性分析。

Patient experiences of prescription drug monitoring programs: a qualitative analysis from an Australian pharmaceutical helpline.

机构信息

School of Psychological Sciences and the Turner Institute for Brain and Mental Health, Monash University, 18 Innovation Walk, Clayton VIC 3800, Australia.

School of Psychological Sciences and the Turner Institute for Brain and Mental Health, Monash University, 18 Innovation Walk, Clayton VIC 3800, Australia.

出版信息

Int J Drug Policy. 2022 Nov;109:103847. doi: 10.1016/j.drugpo.2022.103847. Epub 2022 Sep 5.

Abstract

BACKGROUND

Prescription Drug Monitoring Programs (PDMP) are electronic databases that are used to track and monitor the prescribing and dispensing of controlled substances, such as opioid analgesics and benzodiazepines. PDMP have been used widely throughout North America and have recently been implemented in Australia. Several unintended harms have been associated with PDMP in North America, including increased stigma, discrimination, and dismissal from care for patients prescribed these medications.

AIMS

This study aimed to better understand how people who use prescription medications extramedically and their loved ones give meaning to their consumption and their treatment experiences and concerns in the context of a newly implemented real-time PDMP in Victoria, Australia.

METHOD

Nineteen audio recordings of telephone calls made to the PDMP Pharmaceutical Helpline were transcribed and thematically analysed.

RESULTS

Patients and their families were hopeful that PDMP would stop the extra medical use of medications. However, many were deeply concerned about how they would cope with withdrawal or life stressors without the support these medications afforded. Patients reported experiences of stigma and strained therapeutic relationships associated with PDMP implementation.

CONCLUSION

PDMP have the potential to both assist and harm patients whose prescription medication use has been identified as 'risky' by the PDMP. The findings from this study suggest that clear and open communication, as well as reflection on unconscious bias and stigma may assist healthcare providers to facilitate better patient experiences and outcomes in the context of prescription medication dependence.

摘要

背景

处方药物监测计划(PDMP)是一种电子数据库,用于跟踪和监测受控物质(如阿片类镇痛药和苯二氮䓬类药物)的处方和配药情况。PDMP 在北美得到了广泛应用,并于近期在澳大利亚实施。在北美的 PDMP 带来了一些意料之外的负面影响,包括患者因开此类药物而面临的耻辱感、歧视和被拒诊。

目的

本研究旨在更好地理解在澳大利亚维多利亚州新实施的实时 PDMP 背景下,非医疗目的使用处方药物的患者及其家属如何赋予他们的用药行为意义,以及他们的治疗经历和关注点。

方法

对 PDMP 药品咨询热线的 19 个电话通话录音进行了转录和主题分析。

结果

患者及其家属希望 PDMP 能够阻止药物的非医疗用途。然而,许多人非常担心在没有这些药物支持的情况下,他们将如何应对戒断或生活压力源。患者报告了与 PDMP 实施相关的耻辱感和紧张的治疗关系。

结论

PDMP 既可以帮助也可能伤害那些被 PDMP 识别为“风险”的患者。本研究结果表明,清晰和开放的沟通,以及对无意识偏见和耻辱感的反思,可能有助于医疗保健提供者在药物依赖的背景下,促进更好的患者体验和结果。

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