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弥合纳洛酮使用方面知识与实践的差距:北卡罗来纳州一家机构的经验

Bridging the Gap Between Knowledge and Practices Pertaining to Naloxone Use: A Single-Institution Experience in North Carolina.

作者信息

Argenyi Michael S, Bailey Gisele, McLouth Christopher J, Barnes Erin, McNeil Candice J

机构信息

Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, NC.

Department of Family Medicine and Community Health, University of Massachusetts Chan Medical School, Worcester, MA.

出版信息

J Patient Cent Res Rev. 2025 Apr 22;12(2):76-81. doi: 10.17294/2330-0698.2103. eCollection 2025 Spring.

Abstract

Naloxone is a life-saving medication for opioid overdose, which claims many lives annually. This study investigated provider attitudes about, beliefs about, and barriers to naloxone use to inform an increase in provider prescription of naloxone. The survey took place at a large Southern tertiary health center. An adapted REDCap survey utilizing validated questions was distributed via institutional e-mail listservs. The results (N = 181) were analyzed using descriptive and chi-square statistics. While 90.9% of the providers had heard of the strategy of prescribing naloxone to prevent overdose, only 72.1% of providers would have considered prescribing naloxone. Providers reported implementing treatment or referrals when informed about nonprescribed opioid use (49.4%), when informed about suspected opioid use disorder (50.6%), or when patients asked for opioid use treatment advice or referral (24.4%). Responses indicated that providers are aware of prescribing naloxone to prevent overdose; however, discrepancies existed between providers' knowledge and their willingness to prescribe naloxone. Providers' reluctance to prescribe is partially explained by unfamiliarity with the safety of naloxone and counseling practices surrounding the drug, as well as the belief that prescribing naloxone encourages continued nonprescribed use of opioids. To increase provider comfort, training programs surrounding the safety and counseling practices of naloxone should be implemented.

摘要

纳洛酮是一种用于治疗阿片类药物过量的救命药物,每年有许多人因阿片类药物过量而丧生。本研究调查了医疗服务提供者对纳洛酮使用的态度、看法以及障碍,以促进医疗服务提供者增加纳洛酮的处方量。该调查在南方一家大型三级医疗中心进行。通过机构电子邮件列表分发了一份采用经过验证问题的改编版REDCap调查问卷。使用描述性统计和卡方统计对结果(N = 181)进行了分析。虽然90.9%的医疗服务提供者听说过开具纳洛酮以预防过量用药的策略,但只有72.1%的医疗服务提供者会考虑开具纳洛酮。医疗服务提供者报告称,当得知非处方阿片类药物使用情况(49.4%)、疑似阿片类药物使用障碍情况(50.6%)或患者寻求阿片类药物使用治疗建议或转诊时(24.4%),会实施治疗或进行转诊。调查结果表明,医疗服务提供者了解开具纳洛酮以预防过量用药的情况;然而,医疗服务提供者的知识与他们开具纳洛酮的意愿之间存在差异。医疗服务提供者不愿开具纳洛酮的部分原因是不熟悉纳洛酮的安全性以及围绕该药物的咨询做法,以及认为开具纳洛酮会鼓励继续非处方使用阿片类药物。为了提高医疗服务提供者的舒适度,应实施围绕纳洛酮安全性和咨询做法的培训项目。

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Envisioning Minimally Disruptive Opioid Use Disorder Care.展望微创阿片类药物使用障碍治疗。
J Gen Intern Med. 2023 Feb;38(3):799-803. doi: 10.1007/s11606-022-07939-x. Epub 2022 Nov 18.

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