National Provider Survey: Use of Naltrexone for Pregnant Individuals with Substance Use Disorders.
National Provider Survey: Use of Naltrexone for Pregnant Individuals with Substance Use Disorders.
复制标题
全国提供者调查：纳曲酮对患有药物使用障碍的孕妇的使用。
DOI：
10.1097/adm.0000000000001225
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发表时间：
2023
影响因子：
5.5
通讯作者：
Wachman,ElishaM
中科院分区：
文献类型：
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作者：
Deflorimonte,Chloe;Glissendorf,Viktorria;Hofer,Julia;Cai,Annette;Iannella,Nicole;Boateng,JefferyO;Carter,Ginny;Saia,KelleyA;Jones,HendreeE;Wachman,ElishaM
目标一项全国调查评估了纳曲酮作为妊娠个体酒精使用障碍和/或阿片类药物使用障碍的治疗方法的可用性。还检查了提供者对怀孕期间纳曲酮治疗障碍的看法。方法站点选自纳曲酮处方者国家登记册（N = 5208）。从每个州首府 150 英里以内的地点抽取 10% 的样本 (n= 2073)。调查涉及 11 个问题，包括孕妇能否获得纳曲酮、治疗已经服用纳曲酮的孕妇的标准做法以及治疗障碍。对调查答复进行了总结，以确定服务可用性方面的主要障碍和国家趋势。结果 在所联系的 236 个站点中，78 个站点 (33.1%) 完成了调查。可用站点数量存在显着的地理差异，其中美国东北部拥有最多的站点。在 78 个做出回应的网站中，只有 23 个 (35.9%) 为孕妇提供纳曲酮。开具纳曲酮处方的最常见障碍包括以下内容：没有怀孕患者的场所（15.6%）、缺乏为怀孕患者使用纳曲酮的国家指南（14.1%）、提供者因安全问题而对怀孕期间开具纳曲酮感到不适（9.4%）以及提供者因缺乏经验而感到不适（4.7%）。阿片类药物使用障碍在美国各地差异很大，存在许多障碍和教育差距。需要更多的研究和资源来扩大孕妇接受纳曲酮治疗的机会。
ObjectivesA national survey evaluated the availability of naltrexone as a treatment for alcohol use disorder and/or opioid use disorder for pregnant individuals. Provider perceptions of barriers to treatment with naltrexone during pregnancy were also examined.MethodsSites were selected from a national registry of naltrexone prescribers (N= 5208). A 10% sampling of sites within 150 miles of each state’s capital was selected (n= 2073). Survey of 11 questions included availability of naltrexone for pregnant individuals, standard practices for treating pregnant individuals already on naltrexone, and barriers to treatment. Survey responses were summarized to identify top barriers and national trends in service availability.ResultsOf the 236 sites contacted, 78 (33.1%) completed the survey. There was significant geographic variation in number of available sites, with Northeast United States having the most sites. Of the 78 responding sites, only 23 (35.9%) offered naltrexone for pregnant individuals. The most common barriers to prescribing naltrexone included the following: sites without pregnant patients (15.6%), lack of national guidelines in using naltrexone for pregnant patients (14.1%), providers’ discomfort with prescribing naltrexone during pregnancy due to safety concerns (9.4%), and providers’ discomfort due to inexperience (4.7%)ConclusionsAccessibility of naltrexone and related care for pregnant individuals with alcohol use disorder and opioid use disorder varies greatly across the United States with numerous barriers and educational gaps identified. Additional research and resources are needed to expand naltrexone treatment access for pregnant individuals.