If we build it, will they come? Perspectives on pharmacy-based naloxone among family and friends of people who use opioids: a mixed methods study.
If we build it, will they come? Perspectives on pharmacy-based naloxone among family and friends of people who use opioids: a mixed methods study.
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DOI：
10.1186/s12889-022-13078-z
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发表时间：
2022-04-13
影响因子：
4.5
通讯作者：
Pollini, Robin A.
中科院分区：
文献类型：
--
作者：
Slocum, Susannah;Ozga, Jenny E.;Joyce, Rebecca;Walley, Alexander Y.;Pollini, Robin A.
扩大阿片类拮抗剂纳洛酮的可及性以降低过量死亡率是美国公共卫生的优先事项。许多州已经建立了纳洛酮常备订单（nso），以增加药房的纳洛酮配药，但增加药房准入并不能确保那些可能目睹过量的人获得最佳的纳洛酮。在之前的一次全州范围内的购买试验中，我们记录了在全州NSO下马萨诸塞州药房的高水平纳洛酮获取。在这项研究中，我们描述了潜在的阿片类药物过量“旁观者”（使用阿片类药物的人的朋友或家人）可能接受干预的基于药物的纳洛酮摄取障碍。符合条件的旁观者是年龄≥18岁的马萨诸塞州居民，在过去30天内没有使用非法阿片类药物，并且知道目前有人使用非法阿片类药物。我们采用了顺序混合方法，其中在2018年4月至7月进行了一系列半结构化定性访谈（N = 22），为随后在2020年2月至7月进行的定量调查（N = 260）提供信息。大多数调查参与者（77%）报告曾经获得纳洛酮，但很少（21%）试图在药房购买。定性参与者透露，使用NSO的障碍包括对过量使用的低感知风险，这源于对处方阿片类药物滥用风险的误解，否认他们所爱的人的药物使用以及对药物使用的刻板印象；对纳洛酮对高风险阿片类药物使用影响的不准确认识；以及对预期的耻辱和保密的担忧。许多参与者参加了相互支持小组，这是一半（50%）曾经获得纳洛酮的人免费获得纳洛酮的来源。尽管麻萨诸塞州的药房纳洛酮使用率很高，但在我们的研究中，很少有旁观者试图根据国家统计局获得纳洛酮。用药过量的低感知风险、错误信息、污名化和保密是药房纳洛酮摄取的重要障碍，所有这些都可以进行干预。支持团体提供了一个解决耻辱和错误信息的环境，并为纳洛酮的获取提供了一个谨慎和舒适的环境。在这些群体不存在的地方，对于不参与这些群体的旁观者来说，药店处于有利地位，可以填补纳洛酮供应的空白。
Expanding access to the opioid antagonist naloxone to reduce overdose mortality is a public health priority in the United States. Naloxone standing orders (NSOs) have been established in many states to increase naloxone dispensing at pharmacies, but increased pharmacy access does not ensure optimal uptake among those likely to witness an overdose. In a prior statewide purchase trial, we documented high levels of naloxone access at Massachusetts pharmacies under a statewide NSO. In this study, we characterize barriers to pharmacy-based naloxone uptake among potential opioid overdose “bystanders” (friends or family of people who use opioids) that may be amenable to intervention. Eligible bystanders were Massachusetts residents ≥ 18 years of age, did not use illicit opioids in the past 30 days, and knew someone who currently uses illicit opioids. We used a sequential mixed methods approach, in which a series of semi-structured qualitative interviews (N = 22) were conducted April-July 2018, to inform the development of a subsequent quantitative survey (N = 260), conducted February-July 2020. Most survey participants (77%) reported ever obtaining naloxone but few (21%) attempted to purchase it at a pharmacy. Qualitative participants revealed that barriers to utilizing the NSO included low perceived risk of overdose, which was rooted in misconceptions regarding the risks of prescription opioid misuse, denial about their loved one’s drug use, and drug use stereotypes; inaccurate beliefs about the impact of naloxone on riskier opioid use; and concerns regarding anticipated stigma and confidentiality. Many participants had engaged in mutual support groups, which served as a source of free naloxone for half (50%) of those who had ever obtained naloxone. Despite high levels of pharmacy naloxone access in Massachusetts, few bystanders in our study had attempted to obtain naloxone under the NSO. Low perceived risk of overdose, misinformation, stigma, and confidentiality were important barriers to pharmacy naloxone uptake, all of which are amenable to intervention. Support groups provided a setting for addressing stigma and misinformation and provided a discreet and comfortable setting for naloxone access. Where these groups do not exist and for bystanders who do not participate in such groups, pharmacies are well-positioned to fill gaps in naloxone availability.
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DOI：
10.1016/j.japh.2017.01.013
发表时间：
2017-03-01
影响因子：
2.1
作者：
Green, Traci C.;Case, Patricia;Bratberg, Jeffrey
通讯作者：
Bratberg, Jeffrey
影响因子：
1.3
作者：
Do V;Behar E;Turner C;Geier M;Coffin P
通讯作者：
Coffin P
影响因子：
4.2
作者：
Gertner, Alex K.;Domino, Marisa Elena;Davis, Corey S.
通讯作者：
Davis, Corey S.
影响因子：
4.5
作者：
Doe-Simkins, Maya;Quinn, Emily;Walley, Alexander Y.
通讯作者：
Walley, Alexander Y.
影响因子：
5.5
作者：
Egan, Kathleen L.;Foster, Samantha E.;Lee, Joseph G. L.
通讯作者：
Lee, Joseph G. L.