J Am Pharm Assoc (2003). 2023 Sep-Oct;63(5):1521-1529.e3. doi: 10.1016/j.japh.2023.05.001. Epub 2023 May 4.
Despite national and state policies aimed at increasing naloxone access via pharmacies, opioid overdose death rates rose during the COVID-19 pandemic, particularly among Blacks and American Indians (AIs) in rural areas. Caregivers, or third parties who can administer naloxone during an overdose event, are important individuals in the naloxone administration cascade, yet no studies have explored rural caregivers' opioid overdose terminology and naloxone analogy preferences or whether these preferences differ by race.
To identify rural caregivers' overdose terminology and naloxone analogy preferences and determine whether preferences differ by race.
A sample of 40 caregivers who lived with someone at high risk of overdose and used pharmacies in 4 largely rural states was recruited. Each caregiver completed a demographic survey and a 20- to 45-minute audio-recorded semi-structured interview that was transcribed, de-identified, and imported into a qualitative software package for thematic analysis by 2 independent coders using a codebook. Overdose terminology and naloxone analogy preferences were analyzed for differences by race.
The sample was 57.5% white, 35% Black, and 7.5% AIs. Many participants (43%) preferred that pharmacists use the term "bad reaction" to refer to overdose events over the terms "accidental overdose" (37%) and "overdose" (20%). The majority of white and Black participants preferred "bad reaction" while AI participants preferred "accidental overdose." For naloxone analogies, "EpiPen" was most preferred (64%), regardless of race. "Fire extinguisher" (17%), "lifesaver" (9.5%), and other analogies (9.5%) were preferred by some white and Black participants but not AI participants.
Our findings suggest that pharmacists should use the "bad reaction" term and "EpiPen" analogy when counseling rural caregivers about overdose and naloxone, respectively. Caregivers' preferences varied by race, suggesting that pharmacists may want to tailor the terminology and analogy they use when discussing naloxone with caregivers.
尽管国家和州级政策旨在通过药店增加纳洛酮的获取途径，但在 COVID-19 大流行期间，阿片类药物过量死亡率上升，尤其是在农村地区的黑人和美洲原住民（AI）中。在药物过量事件中可以给予纳洛酮的护理人员或第三方是纳洛酮给药级联中的重要人员，但尚无研究探讨农村护理人员的阿片类药物过量术语和纳洛酮类比偏好，或者这些偏好是否因种族而异。
确定农村护理人员的药物过量术语和纳洛酮类比偏好，并确定这些偏好是否因种族而异。
从 4 个主要以农村为主的州的药店中招募了 40 名与高危药物过量者同住的护理人员组成样本。每位护理人员都完成了一份人口统计调查和一份 20-45 分钟的录音半结构化访谈，访谈内容被转录、去识别，并导入到一个定性软件包中，由 2 名独立的编码员使用代码本进行主题分析。分析了种族差异对药物过量术语和纳洛酮类比偏好的影响。
该样本中，57.5%为白人，35%为黑人，7.5%为 AI。许多参与者（43%）更喜欢药剂师使用“不良反应”一词来指代药物过量事件，而不是“意外药物过量”（37%）和“药物过量”（20%）。大多数白人参与者和黑人参与者更喜欢“不良反应”，而 AI 参与者则更喜欢“意外药物过量”。对于纳洛酮类比，“EpiPen”是最受欢迎的（64%），无论种族如何。“灭火器”（17%）、“救生员”（9.5%）和其他类比（9.5%）则受到一些白人参与者和黑人参与者的青睐，但不受 AI 参与者的青睐。
我们的研究结果表明，药剂师在为农村护理人员提供药物过量和纳洛酮方面的咨询时，应分别使用“不良反应”一词和“EpiPen”类比。护理人员的偏好因种族而异，这表明药剂师在与护理人员讨论纳洛酮时可能希望调整他们使用的术语和类比。
