Snyder Sabrina, Butala Niyati, Williams Andrew M, Kneebusch Jamie
Department of Pharmacy, Arlington Campus, Riverside University Health System, Riverside, CA 92503, USA.
Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, CA 92093, USA.
Pharmacy (Basel). 2024 Feb 1;12(1):26. doi: 10.3390/pharmacy12010026.
Individuals with mental illness have a high incidence of comorbid substance use, with one of the most prevalent being alcohol use disorder (AUD). Naltrexone, FDA-approved for AUD, decreases reward associated with alcohol-related social cues. This study aimed to determine if a pharmacist-driven screening tool would increase the use of extended-release naltrexone (XR-NTX) in patients with AUD and a comorbid psychiatric condition. Pharmacists screened and recommended XR-NTX for adults admitted to the inpatient psychiatric unit, who had a DSM-5 diagnosis of AUD, a negative urine drug screen for opioids, and were hospitalized for at least 1 day. Endpoints evaluated included the number of XR-NTX doses administered during the screening period to the prescreening period, 30-day readmission rates, recommendation acceptance rates, and reasons for not administering XR-NTX. Pharmacists identified 66 of 641 screened patients who met the inclusion criteria and were candidates for XR-NTX. Compared to the preintervention period, more patients received XR-NTX for AUD (2 vs. 8). Readmission rates were similar between those with AUD who received XR-NTX and those who did not. Pharmacist-driven screening for AUD led to greater administration of XR-NTX when compared to the same 4-month period the year prior to initiating the study.
患有精神疾病的个体共病物质使用的发生率很高,其中最普遍的一种是酒精使用障碍(AUD)。已获美国食品药品监督管理局(FDA)批准用于治疗AUD的纳曲酮,可降低与酒精相关社交线索相关的奖赏感。本研究旨在确定由药剂师主导的筛查工具是否会增加缓释纳曲酮(XR-NTX)在患有AUD且合并精神疾病的患者中的使用。药剂师对入住住院精神科病房的成年人进行筛查并推荐使用XR-NTX,这些成年人符合《精神疾病诊断与统计手册》第5版(DSM-5)中AUD的诊断标准,尿液阿片类药物筛查呈阴性,且住院至少1天。评估的终点指标包括筛查期与筛查前期给予的XR-NTX剂量数量、30天再入院率、推荐接受率以及未给予XR-NTX的原因。药剂师在641名接受筛查的患者中识别出66名符合纳入标准且为XR-NTX候选对象的患者。与干预前期相比,更多患者因AUD接受了XR-NTX治疗(2例对8例)。接受XR-NTX治疗的AUD患者与未接受治疗的患者的再入院率相似。与开展该研究前一年的同一4个月期间相比,由药剂师主导的AUD筛查导致了更多的XR-NTX给药。