The Impact of a Peer-Navigator Program on Naloxone Distribution and Buprenorphine Utilization in the Emergency Department
The Impact of a Peer-Navigator Program on Naloxone Distribution and Buprenorphine Utilization in the Emergency Department
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DOI：
10.1080/10826084.2021.2023187
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发表时间：
2021-12-27
影响因子：
2
通讯作者：
Nelson, Lewis
中科院分区：
文献类型：
--
作者：
Ramdin, Christine;Guo, Marshall;Nelson, Lewis
目的：近年来，许多急诊科（ED）采取干预措施来帮助阿片类药物使用障碍（OUD）患者，特别是丁丙诺啡启动和基于ED的同伴康复支持。关于同行导航员对供应商纳洛酮试剂盒分配和丁丙诺啡使用的影响的数据有限。我们的目的是研究同伴康复计划对纳洛酮药盒分发和丁丙诺啡给药的影响。方法：回顾性研究分析纳洛酮药盒的销售变化以及丁丙诺啡给药情况。2017年11月至2021年2月期间，每月生成纳洛酮药盒和丁丙诺啡给药数据。时间段如下：实施丁丙诺啡和纳洛酮试剂盒指南，启动领航员计划，以及第一波COVID-19。计算每月分发的纳洛酮药盒数量和丁丙诺啡给药数量。结果：2017年11月至2020年12月期间，分发的238个纳洛酮套件随时间推移显着增加（p < 0.0001）。在实施指南和引入同行导航员之间，分发了49个工具包，而导航员项目开始时，235个工具包随时间增加（p = 0.0001）。在1797次丁丙诺啡给药中，随时间推移也有显著增加（p < 0.0001）。实施导航程序后，管理增加了22.4%，共787例，而指南后为643例（p = 0.007）。结论：OUD患者的同伴康复支持计划可能会影响纳洛酮药盒和丁丙诺啡的给药。未来的研究应该确定这些计划是否会导致ED的长期文化变化。
Objectives: In recent years many emergency departments (EDs) have adopted interventions to help patients with opioid use disorder (OUD), particularly buprenorphine initiation and ED-based peer recovery support. There are limited data on the impact of peer navigators on provider naloxone kit distribution and buprenorphine utilization. We aimed to examine the impact of a peer recovery program on naloxone kit distribution and buprenorphine administration. Methods: This was a retrospective study analyzing the change in naloxone kits distributed as well as buprenorphine administrations. Data on naloxone kit and buprenorphine administrations was generated every month between November 2017 and February 2021. Time periods were as follows: implementation of guidelines for buprenorphine and naloxone kits, initiation of the navigator program, and first wave of COVID-19. Numbers of naloxone kits distributed and buprenorphine administrations per month were computed. Results: Between November 2017 and December 2020, there was a significant increase overtime among the 238 naloxone kits distributed (p < 0.0001). Between implementation of guidelines and introduction of peer navigators, there were 49 kits distributed, compared to an increase overtime among 235 kits when the navigator program began (p = 0.0001). There was also a significant increase overtime among 1797 administrations of buprenorphine (p < 0.0001). Administrations increased by 22.4% after implementation of the navigator program-a total of 787 compared to 643 post guideline (p = 0.007). Conclusion: Peer recovery support programs for patients with OUD can have an impact on administration of naloxone kits and buprenorphine. Future studies should determine whether these programs can cause a long-term culture change in the ED.