Primary Care Physicians' Knowledge And Attitudes Regarding Prescription Opioid Abuse and Diversion
Primary Care Physicians' Knowledge And Attitudes Regarding Prescription Opioid Abuse and Diversion
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DOI：
10.1097/ajp.0000000000000268
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发表时间：
2016-04-01
影响因子：
2.9
通讯作者：
Alexander, G. Caleb
中科院分区：
文献类型：
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作者：
Hwang, Catherine S.;Turner, Lydia W.;Alexander, G. Caleb
目标：医生是处方阿片类药物滥用流行的关键利益相关者。因此，我们评估了他们对阿片类药物滥用和转移的了解，以及他们对临床和监管干预措施的支持，以减少阿片类药物相关的发病率和死亡率。 材料和方法：我们在 2014 年 2 月至 5 月期间对美国 1000 名执业内科医生、家庭医生和全科医生进行了一项具有全国代表性的邮寄调查。结果：调整后的反应率为 58%，所有医生 (100%) 认为处方药虐待是他们社区中的一个问题。然而，只有三分之二 (66%) 的人正确报告最常见的滥用途径是吞服整个药丸，而近一半 (46%) 的人错误地报告防滥用制剂的成瘾性低于同类制剂。此外，少数医生 (25%) 表示“完全不”或“只是稍微担心”阿片类药物从合法市场转移到非法市场的可能性，因为这种做法在药品供应链的各个层面都很常见。大多数医生支持采取临床和监管干预措施来减少处方阿片类药物滥用，包括使用患者合同（98%）、尿液药物检测（90%）、要求处方者在开阿片类药物处方前检查集中数据库（88%），以及对阿片类药物的营销和促销实行更严格的限制（77%至82%）。尽管如此，只有三分之一 (33%) 的医生认为，减少处方阿片类药物滥用的干预措施对阻止患者在临床上适当获得疼痛治疗有中度或较大影响。讨论：尽管医生不了解处方阿片类药物相关发病率的某些方面，但大多数医生支持采取各种临床和监管干预措施，以改善这些疗法的风险收益平衡。
Objectives:Physicians are a key stakeholder in the epidemic of prescription opioid abuse. Therefore, we assessed their knowledge of opioid abuse and diversion, as well as their support for clinical and regulatory interventions to reduce opioid-related morbidity and mortality.Materials and Methods:We conducted a nationally representative postal mail survey of 1000 practicing internists, family physicians, and general practitioners in the United States between February and May 2014.Results:The adjusted response rate was 58%, and all physicians (100%) believed that prescription drug abuse was a problem in their communities. However, only two-thirds (66%) correctly reported that the most common route of abuse was swallowing pills whole, and nearly one-half (46%) erroneously reported that abuse-deterrent formulations were less addictive than their counterparts. In addition, a notable minority of physicians (25%) reported being "not at all" or "only slightly concerned" about the potential for opioid diversion from the licit to the illicit market when this practice is common at all levels of the pharmaceutical supply chain. Most physicians supported clinical and regulatory interventions to reduce prescription opioid abuse, including the use of patient contracts (98%), urine drug testing (90%), requiring prescribers to check a centralized database before prescribing opioids (88%), and instituting greater restrictions on the marketing and promotion of opioids (77% to 82%). Despite this, only one-third of physicians (33%) believed that interventions to reduce prescription opioid abuse had a moderate or large effect on preventing patients' clinically appropriate access to pain treatment.Discussion:Although physicians are unaware of some facets of prescription opioid-related morbidity, most support a variety of clinical and regulatory interventions to improve the risk-benefit balance of these therapies.