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原文重现:评估在经历阿片类药物相关过量事件的退伍军人人群中实施纳洛酮分发计划。

Reprint of: Assessment of a naloxone distribution plan in a veteran population who experienced an opioid-related overdose event.

出版信息

J Am Pharm Assoc (2003). 2024 Jul-Aug;64(4S):102168. doi: 10.1016/j.japh.2024.102168. Epub 2024 Aug 10.

Abstract

BACKGROUND

The Veteran Health Administration prioritizes the distribution of naloxone to veterans diagnosed with opioid use disorder (OUD) to prevent deaths due to opioid-related overdose. The Overdose Education and Naloxone Distribution (OEND) program was created with tools to supplement efforts in identifying veterans at risk of opioid-related adverse events secondary to OUD or other comorbidities and increase access, education, and distribution of naloxone. Utilizing the OEND tool, Veteran Health Indiana (VHI) employed two different distribution initiatives to increase access to naloxone.

OBJECTIVE

The purpose of this study is to assess naloxone distribution efforts at a United States Department of Veterans Affairs medical center and evaluate outcomes in patients who experienced opioid overdose events before and after the OEND initiatives were implemented. The primary outcome is to assess the distribution of naloxone within the year prior to the documented overdose event before and after the OEND initiatives. Secondary outcomes include assessment of the number of naloxone doses administered during the overdose event, substances involved in the overdose, and distribution of outpatient naloxone prescriptions after the overdose event.

METHODS

This study was a retrospective electronic chart review of all patients who experienced an opioid-related overdose event at VHI from March 1, 2019, to March 1, 2022.

RESULTS

Of the 59 opioid-overdose events analyzed, the percentage of patients with a naloxone prescription within 12 months prior to an opioid-overdose event was similar between the pre- and post-OEND initiatives. Within 12 months following the overdose event, naloxone was dispensed to nearly 10% more patients in the post-OEND group compared to the pre-OEND group.

CONCLUSIONS

The OEND initiatives increased naloxone distribution amongst patients who ultimately experienced an opioid-related overdose. Additional research is needed to assess if these efforts prevented further overdoses.

摘要

背景

退伍军人健康管理局优先向被诊断患有阿片类药物使用障碍(OUD)的退伍军人分发纳洛酮,以防止阿片类药物相关过量导致的死亡。过量用药教育和纳洛酮分发(OEND)计划提供了工具,以补充识别因 OUD 或其他合并症而有阿片类药物相关不良事件风险的退伍军人的工作,并增加纳洛酮的获取、教育和分发。印第安纳州退伍军人健康(VHI)利用 OEND 工具实施了两项不同的分发计划,以增加纳洛酮的获取途径。

目的

本研究旨在评估美国退伍军人事务部医疗中心的纳洛酮分发工作,并评估在实施 OEND 计划前后经历阿片类药物过量事件的患者的结局。主要结局是评估在实施 OEND 计划前后,在记录的过量事件前一年纳洛酮的分发情况。次要结局包括评估在过量事件中给予的纳洛酮剂量数、过量涉及的物质,以及过量事件后门诊纳洛酮处方的分发情况。

方法

本研究是对 2019 年 3 月 1 日至 2022 年 3 月 1 日期间在 VHI 经历阿片类药物相关过量事件的所有患者进行的回顾性电子病历审查。

结果

在分析的 59 例阿片类药物过量事件中,在阿片类药物过量事件前 12 个月内有纳洛酮处方的患者百分比在 OEND 计划实施前后相似。在过量事件发生后的 12 个月内,与 OEND 前组相比,OEND 后组中有近 10%的患者获得了纳洛酮。

结论

OEND 计划增加了最终经历阿片类药物相关过量事件的患者的纳洛酮分发。需要进一步研究以评估这些努力是否防止了进一步的过量。

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