Outpatient Provider Contact Prior to Unintentional Opioid Overdose Among VHA Service Users.
Outpatient Provider Contact Prior to Unintentional Opioid Overdose Among VHA Service Users.
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VHA 服务用户意外服用阿片类药物过量之前与门诊提供者联系。
DOI：
10.1176/appi.ps.201400194
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发表时间：
2015
期刊：
影响因子：
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通讯作者：
Blow,FredericC
中科院分区：
文献类型：
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作者：
Lin,LeweiAllison;Bohnert,AmySB;Ilgen,MarkA;Pfeiffer,PaulN;Ganoczy,Dara;Blow,FredericC
目的阿片类药物处方是最常见的涉及物质在无意过量。门诊医疗保健接触代表了干预以减少阿片类药物过量风险的潜在机会。本研究评估的时间和类型的门诊提供者接触死亡前无意处方阿片类药物overdose.MethodsThis研究检查了所有成年患者在全国退伍军人健康管理局（VHA）谁死于无意处方阿片类药物过量在2004-2007财政年度，谁使用VHA服务的任何时间在两年内他们的死亡（N=1,813）。对于那些最后的治疗接触是在门诊设置（N=1,457），人口统计学，临床和治疗特征进行了比较，患者分类的位置，他们的最后contact.ResultsAmong个人最后看到在门诊设置，33%被视为一个星期内，他们的过量和62%在一个月内，他们的过量。相当大比例的患者（30%）在精神健康或物质使用障碍门诊环境中死亡后一个月内最后一次就诊。大多数患者（86%）没有填写阿片类药物处方在他们的最后一次门诊就诊之前，无意阿片类药物过量死亡。ConclusionsMost无意处方阿片类药物过量死亡的患者被认为是在一个月内，他们过量的门诊设置。这些设置可以提供一个机会，以防止患者死于处方阿片类药物过量。降低风险的干预措施不应仅限于处方阿片类药物的就诊。
ObjectivesPrescription opioid medications are the most commonly implicated substances in unintentional overdoses. Outpatient health care encounters represent a potential opportunity to intervene to reduce opioid overdose risk. This study assessed the timing and type of outpatient provider contacts prior to death from unintentional prescription opioid overdose.MethodsThis study examined all adult patients nationally in the Veterans Health Administration (VHA) who died from unintentional prescription opioid overdose in fiscal years 2004–2007 and who used VHA services anytime within two years of their deaths (N=1,813). For those whose final treatment contact was in an outpatient setting (N=1,457), demographic, clinical, and treatment characteristics were compared among patients categorized by the location of their last contact.ResultsAmong individuals last seen in outpatient settings, 33% were seen within one week of their overdose and 62% within one month of their overdose. A substantial proportion of patients (30%) were last seen within one month of death in mental health or substance use disorder outpatient settings. The majority of patients (86%) did not fill an opioid prescription on their last outpatient visit prior to death from unintentional opioid overdose.ConclusionsMost patients who died by unintentional prescription opioid overdose were seen in outpatient settings within a month of their overdose. These settings may provide an opportunity to prevent patients from dying from prescription opioid overdoses. Interventions to reduce risk should not be limited to visits during which an opioid is prescribed.