A Survey of Prescribers' Attitudes, Knowledge, Comfort, and Fear of Consequences Related to an Opioid Overdose Education and Naloxone Distribution Program
A Survey of Prescribers' Attitudes, Knowledge, Comfort, and Fear of Consequences Related to an Opioid Overdose Education and Naloxone Distribution Program
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DOI：
10.1097/phh.0000000000000668
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发表时间：
2018-07-01
影响因子：
3.3
通讯作者：
Boggs, Douglas L.
中科院分区：
文献类型：
--
作者：
Peckham, Alyssa M.;Niculete, Maria E.;Boggs, Douglas L.
背景：阿片类药物相关死亡人数的惊人增加使美国处于阿片类药物流行病之中。为了减少阿片类药物相关的死亡，每个退伍军人事务部（VA）医院负责开发一个OEND（过量教育和纳洛酮分布）计划，以提高纳洛酮分布.目的：评估态度，知识，舒适度，和恐惧的后果，在处方水平有关的OEND计划在弗吉尼亚州康涅狄格州医疗保健系统（VACHS）.设计：对VACHS处方者进行匿名调查，以评估态度、知识、舒适度和对后果的恐惧，使用5分Likert量表。VACHS处方者（初级保健医生/内科医生、精神科医生、医师助理/高级执业注册护士、药剂师），方法：使用方差分析检验分析4个领域的差异，并使用Tukey的HSD对所有显著结果进行成对事后分析。回归建模进行评估各组和survey responses.Main Outcome之间的相关性：确定差异和潜在的障碍，以跨专业和实践specialty.Results的方案实施：而初级保健/医学，心理健康，和SUD处方者对配药纳洛酮的积极态度，SUD临床医生报告更舒适，更有知识，和更少的恐惧的后果。一般来说，精神科医生报告说，他们更了解纳洛酮，也更愿意开纳洛酮。此外，接受纳洛酮培训的处方医生报告说，他们自己更舒适，更有知识，更少的恐惧的后果分配naloxone.Conclusions：结果表明，障碍OEND的实施继续存在，并不是所有的临床医生或实践专业在VACHS是舒适的分配纳洛酮。有针对性的方法来培训医疗保健临床医生可能会导致纳洛酮配药的接受度提高。需要进行更多的研究，以得出提高纳洛酮接受度的最佳方法，以扩大纳洛酮的使用。
Context: The alarming increase in opioid-related fatalities has placed the United States in the midst of an opioid epidemic. In an effort to reduce opioid-related fatalities, each Veterans Affairs (VA) hospital is responsible for development of an OEND (Overdose Education and Naloxone Distribution) program to enhance naloxone distribution.Objective: To assess attitudes, knowledge, comfort level, and fear of consequences at the prescriber level related to the OEND program at VA Connecticut Healthcare System (VACHS).Design: Anonymous surveys were administered to VACHS prescribers to assess attitude, knowledge, comfort level, and fear of consequences using a 5-point Likert scale.Setting: VACHS.Participants: VACHS prescribers (primary care physicians/internists, psychiatrists, physician assistants/advanced practice registered nurses, pharmacists) in primary care/medicine, mental health, and substance use disorder (SUD).Methods: Differences across 4 domains were analyzed using analysis of variance testing, and pairwise post hoc analysis was conducted using Tukey's HSD for all significant findings. Regression modeling was conducted to evaluate correlations between each group and survey responses.Main Outcome: Identify differences and potential barriers to program implementation across professions and practice specialty.Results: While primary care/medicine, mental health, and SUD prescribers had positive attitudes toward dispensing naloxone, SUD clinicians reported being more comfortable, more knowledgeable, and less fearful of consequences. In general, psychiatrists reported to be more knowledgeable and comfortable prescribing naloxone. In addition, prescribers who received naloxone training reported themselves to be more comfortable, more knowledgeable, and less fearful of the consequences of dispensing naloxone.Conclusions: Results indicate that barriers to OEND implementation continue to exist, and not all clinicians or practice specialties at VACHS are comfortable with dispensing naloxone. A targeted approach to training health care clinicians may lead to increased acceptance of naloxone dispensing. Additional research is needed to elicit the best method of improved acceptance of naloxone to expand naloxone access.