Mercer Fiona, Parkes Tessa, Foster Rebecca, Steven Deborah, McAuley Andrew, Baldacchino Alexander, Steele Wez, Schofield Joe, Matheson Catriona
Salvation Army Centre for Addiction Services and Research, Faculty of Social Sciences, University of Stirling, Stirling, UK.
NHS Fife, Kirkcaldy, UK.
Drug Alcohol Rev. 2023 Mar;42(3):517-526. doi: 10.1111/dar.13554. Epub 2022 Sep 27.
Despite opioid prescribing for chronic non-cancer pain (CNCP) having limited therapeutic benefits, recent evidence indicates significant increases in the prescribing of high-strength opioids for individuals with CNCP. Patients prescribed opioids for CNCP have overdose risk factors but generally have low opioid overdose awareness and low perceptions of risk related to prescribed opioids. Currently, there are few bespoke overdose prevention resources for this group.
This qualitative study investigated views on a naloxone intervention for people prescribed high-strength opioids for CNCP delivered via community pharmacies. The intervention included overdose risk awareness and naloxone training and provision. Interviews were conducted with eight patients, four family members and two community pharmacists. Participants were convenience sampled and recruited through networks within the Scottish pain community. The Framework approach was used to analyse findings.
All participants had positive attitudes towards the intervention, but patients and family members considered risk of overdose to be very low. Three themes were identified: potential advantages of the intervention; potential barriers to the intervention; and additional suggestions and feedback about the intervention. Advantages included the intervention providing essential overdose information for CNCP patients. Barriers included resource and time pressures within community pharmacies.
While patients had low overdose knowledge and did not see themselves as being at risk of opioid overdose, they were receptive to naloxone use and positive about the proposed intervention. A feasibility trial is merited to further investigate how the intervention would be experienced within community pharmacy settings.
尽管为慢性非癌性疼痛(CNCP)开具阿片类药物的治疗益处有限,但最近的证据表明,为患有CNCP的个体开具高强度阿片类药物的处方量显著增加。因CNCP而被开具阿片类药物的患者存在过量用药风险因素,但总体上对阿片类药物过量的认识较低,对与所开阿片类药物相关的风险认知也较低。目前,针对该群体的定制过量用药预防资源很少。
这项定性研究调查了通过社区药房为因CNCP而被开具高强度阿片类药物的人群进行纳洛酮干预的相关观点。该干预包括过量用药风险意识、纳洛酮培训和供应。对8名患者、4名家庭成员和2名社区药剂师进行了访谈。参与者是通过苏格兰疼痛社区内的网络进行便利抽样和招募的。采用框架法对研究结果进行分析。
所有参与者对该干预都持积极态度,但患者和家庭成员认为过量用药的风险非常低。确定了三个主题:干预的潜在优势;干预的潜在障碍;以及关于干预的其他建议和反馈。优势包括该干预为CNCP患者提供了重要的过量用药信息。障碍包括社区药房的资源和时间压力。
虽然患者对过量用药的知识了解较少,且不认为自己有阿片类药物过量的风险,但他们接受纳洛酮的使用,并对拟议的干预持积极态度。值得进行一项可行性试验,以进一步研究在社区药房环境中如何实施该干预。