Emergency department physicians' and pharmacists' perspectives on take-home naloxone
Emergency department physicians' and pharmacists' perspectives on take-home naloxone
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DOI：
10.1111/dar.12894
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发表时间：
2019-02-01
影响因子：
3.8
通讯作者：
Chaar, Betty
中科院分区：
文献类型：
--
作者：
Holland, Taylor J.;Penm, Jonathan;Chaar, Betty
前言和目的阿片类药物过量是世界范围内日益严重的负担，也是澳大利亚死亡的主要原因。为了减少与阿片类药物相关的死亡人数，在澳大利亚，纳洛酮的可带回家性已经扩大，现在无需处方即可获得。由于经常遇到阿片类药物过量的患者，急诊科（ED）可能是分发带回家的纳洛酮的理想场所。本研究的目的是了解急诊科医生和药剂师在急诊科使用纳洛酮的观点。设计与方法对急诊科医生和药剂师进行半结构化访谈，了解他们对纳洛酮带回家的看法。参与者是通过专业团体的参与和“滚雪球式”招聘来招募的。访谈录音并逐字抄录，以便采用归纳专题方法进行分析。结果共对13名药师和12名医师进行了25次访谈。回答分为三个主题：(i)态度——大多数参与者原则上支持带回家的纳洛酮，但有许多担忧；（ii）临床应用——在患者使用、实施和药理作用方面提出了挑战；（iii）后勤方面的考虑——其中讨论了与从急诊科分发带回家的纳洛酮有关的许多障碍，如时间考虑、教育和资源。尽管大多数人支持纳洛酮带回家，但参与者发现了在急诊科使用纳洛酮带回家的障碍。未来，重点应放在对急诊科工作人员进行纳洛酮带回家的教育和培训，并实施标准化的方案。
Introduction and Aims Opioid overdose is an increasing burden world-wide and is a major cause of death in Australia. To reduce the number of opioid-related deaths, access to take-home naloxone has expanded in Australia and is now accessible without prescription. Emergency departments (ED) could be ideal settings for the distribution of take-home naloxone, due to regular encounters with patients who experience opioid overdoses. The aim of this study was to gain insight into ED physicians' and pharmacists' perspectives on take-home naloxone in the ED setting. Design and Methods Semi-structured interviews were carried out with ED physicians and pharmacists about their perceptions of take-home naloxone. Participants were recruited through their involvement with professional bodies and through 'snowball' recruitment. Interviews were audio recorded and transcribed verbatim to be analysed using an inductive thematic approach. Results Twenty-five interviews were conducted with 13 pharmacists and 12 physicians. Responses were categorised into three main themes: (i) Attitudes-the majority of participants supported take-home naloxone in principle, but had numerous concerns; (ii) Clinical Application-where challenges in terms of its patient use, implementation and pharmacological actions were raised; and (iii) Logistical Considerations-where many hindrances in relation to the distribution of take-home naloxone from the ED such as time considerations, education and resourcing were discussed. Discussion and Conclusions Despite the majority supporting take-home naloxone, participants identified barriers to take-home naloxone in the ED. In the future, emphasis should be placed on educating and training staff in the ED about take-home naloxone and implementing standardised protocols.