Schofield Joe, Parkes Tessa, Mercer Fiona, Foster Rebecca, Hnízdilová Kristina, Matheson Catriona, Steele Wez, McAuley Andrew, Raeburn Fiona, Skea Lucy, Baldacchino Alexander
Salvation Army Centre for Addiction Services and Research, Faculty of Social Sciences, University of Stirling, Stirling FK9 4LA, UK.
NHS Lanarkshire, Bothwell G71 8BB, UK.
Pharmacy (Basel). 2023 May 22;11(3):88. doi: 10.3390/pharmacy11030088.
There have been increases in prescriptions of high strength opioids for chronic non-cancer pain (CNCP), but CNCP patients perceive themselves as being at low risk of opioid overdose and generally have limited overdose awareness. This study examined how an overdose prevention intervention (opioid safety education, naloxone training, and take-home naloxone (THN)) delivered by community pharmacists for patients prescribed high-strength opioids for CNCP would work in practice in Scotland. Twelve patients received the intervention. CNCP patients and Community Pharmacists were interviewed about their experiences of the intervention and perceptions of its acceptability and feasibility. CNCP patients did not initially perceive themselves as being at risk of overdose but, through the intervention, developed insight into opioid-related risk and the value of naloxone. Pharmacists also identified patients' low risk perceptions and low overdose awareness. While pharmacists had positive attitudes towards the intervention, they outlined challenges in delivering it under time and resource pressures and during the COVID-19 pandemic. Overdose prevention interventions are required in the CNCP population as this group has elevated risk factors for overdose but are commonly overlooked. Customised overdose prevention interventions for CNCP patients attend to gaps in overdose awareness and risk perceptions in this population.
用于慢性非癌性疼痛（CNCP）的高强度阿片类药物处方量有所增加，但CNCP患者认为自己阿片类药物过量风险较低，且普遍对过量用药的认知有限。本研究探讨了社区药剂师为开具高强度阿片类药物治疗CNCP的患者提供的过量用药预防干预措施（阿片类药物安全教育、纳洛酮培训及纳洛酮带回家（THN））在苏格兰的实际效果。12名患者接受了该干预措施。研究人员就干预措施的体验以及对其可接受性和可行性的看法，对CNCP患者和社区药剂师进行了访谈。CNCP患者最初并不认为自己有过量用药风险，但通过干预，对阿片类药物相关风险及纳洛酮的价值有了认识。药剂师也发现了患者对风险的认知不足和对过量用药的了解有限。虽然药剂师对该干预措施持积极态度，但他们也概述了在时间和资源压力下以及在新冠疫情期间实施该措施所面临的挑战。CNCP人群需要过量用药预防干预措施，因为该群体过量用药的风险因素较高，但通常被忽视。针对CNCP患者的定制化过量用药预防干预措施关注了该人群在过量用药认知和风险认知方面的差距。
