Morgan Wiggins, MSN, APRN, PMHNP-BC, Case Western Reserve University, Cleveland, OH, USA; DNP, APRN, PMHNP-BC, The Ohio State University College of Nursing, Columbus, OH, USA.
Susan Painter, DNP, APRN, C-CNS, PMHCNS-BC, Case Western Reserve University, Cleveland, OH, USA.
J Am Psychiatr Nurses Assoc. 2024 May-Jun;30(3):613-623. doi: 10.1177/10783903221151062. Epub 2023 Jan 24.
Alcohol use disorder (AUD) is overrepresented within the United States. Naltrexone, a recommended treatment for AUD, is underutilized. However, the prescribing behaviors of advanced practice registered nurses (APRNs) regarding naltrexone for AUD patients have not been studied. The purpose of our study was to explore the prescriptive practices of a sample of APRNs.
To describe and analyze survey responses of a sample of Ohio APRNs with training in medication for addiction treatment (MAT) for substance use disorders (as evidenced by DEA x-waiver receipt) regarding prescribing practices of naltrexone for AUD patients.
Public information collected from the first author's Nursing Board (list of APRNs in Ohio) was checked against the public information of x-waivered providers nationally from the Substance Abuse and Mental Health Services Administration's (SAMHSA) website. This generated a potential sample size of 824 APRNs, all of whom were sent email solicitations to complete a Qualtrics survey. After 3 weeks, 55 surveys were completed, and the data were analyzed. Descriptive statistics were generated as well as a logistic regression with five potential predictor variables against the outcome variable (defined as use of naltrexone for AUD patients).
Years practicing as an APRN was found to negatively predict naltrexone prescribing behavior for AUD patients. Practice setting and work experience with an addiction specialist physician were not found to predict naltrexone prescribing behavior for AUD patients.
Implications for further study were discussed, with emphasis on regulatory variance between states.
在美国，酒精使用障碍（AUD）的发病率过高。纳曲酮是 AUD 的推荐治疗药物，但未得到充分利用。然而，对于 AUD 患者使用纳曲酮，高级实践注册护士（APRN）的处方行为尚未得到研究。我们研究的目的是探索 APRN 样本的处方实践。
描述和分析具有药物治疗成瘾（MAT）培训的俄亥俄州 APRN 样本的调查回复，这些 APRN 接受过治疗物质使用障碍的培训（表现为 DEA x 豁免获得），以了解他们为 AUD 患者开纳曲酮的处方实践。
从第一作者的护理委员会（俄亥俄州 APRN 名单）中收集的公共信息与物质滥用和心理健康服务管理局（SAMHSA）网站上全国 x 豁免提供者的公共信息进行核对。这产生了一个潜在的样本大小为 824 名 APRN，他们都收到了完成 Qualtrics 调查的电子邮件邀请。3 周后，完成了 55 份调查，然后对数据进行了分析。生成了描述性统计数据，以及一个具有五个潜在预测变量的逻辑回归，针对的是因变量（定义为使用纳曲酮治疗 AUD 患者）。
作为 APRN 的执业年限被发现与 AUD 患者使用纳曲酮的处方行为呈负相关。实践环境和与成瘾专家医生的工作经验未被发现与 AUD 患者使用纳曲酮的处方行为相关。
讨论了进一步研究的意义，重点是州际之间的监管差异。
