Opioid Prescribing in Rural Family Practices: A Qualitative Study
Opioid Prescribing in Rural Family Practices: A Qualitative Study
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DOI：
10.1080/10826084.2017.1342659
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发表时间：
2018-01-01
影响因子：
2
通讯作者：
Tudiver, Fred
中科院分区：
文献类型：
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作者：
Click, Ivy A.;Basden, Jeri Ann;Tudiver, Fred
背景：近年来，田纳西州农村地区，尤其是东田纳西州农村地区的受控药物处方率和受控药物过量死亡率急剧上升。然而，对于与成瘾问题相关的个人开药或继续处方的决定知之甚少。目的：本研究的目的是通过焦点小组更多地了解哪些因素导致医生开出治疗非癌症疼痛的控制药物。方法：利用焦点小组对田纳西州东部和弗吉尼亚州西南部的五个家庭医学诊所进行定性研究。研究人员使用了半结构化访谈指南，旨在促进有关处方药滥用和误用的小组讨论。结果：焦点小组确定了四个主题：（1）处方者随时间变化的处方模式； （二）影响管制药物处方的因素； (3) 国家处方药监测计划 (PDMP) 的使用和使用障碍； (4)给育龄妇女开管制药物。每个主题都有几个子主题。结论：治疗患者症状和造成潜在伤害之间的平衡是一个挑战。患者的痛苦不容忽视，但阿片类药物治疗的潜在危害也不容小觑。随着阿巴拉契亚农村地区处方药滥用的公共卫生问题不断蔓延，处方医生意识到他们与问题的联系，并最终找到解决方案。
Background: Rural Tennessee, especially rural East Tennessee has seen a dramatic increase in rates of controlled drug prescriptions and controlled drug overdose deaths in recent years. However, little is known about the individual decisions to prescribe or continue prescriptions with relation to addiction concerns. Objectives: The purpose of this study was to learn more about what factors lead to physicians' prescribing control drugs for non-cancer pain through the use of focus groups. Methods: A qualitative study, using focus groups, in five family medicine clinics in East Tennessee and Southwest Virginia. The investigators used a semi-structured interview guide designed to facilitate group discussions about prescription drug abuse and misuse. Results: There were four main themes identified by the focus groups: (1) prescribers' changing prescribing patterns over time; (2) factors that influence controlled drug prescribing; (3) use and barriers to using state prescription drug monitoring programs (PDMPs); (4) prescribing controlled drugs to women of childbearing age. Each theme had several subthemes. Conclusions: The balance between treating the patient's symptoms and causing potential harm is a challenge. The patient's pain cannot be ignored, but the potential harm of opioid therapy is not taken lightly. As the public health concern of prescription drug abuse in rural Appalachia continues to spread, prescribers are aware of their connection to the problem, and ultimately the solution.