How do contextual factors influence naloxone distribution from syringe service programs in the USA: a cross-sectional study.
How do contextual factors influence naloxone distribution from syringe service programs in the USA: a cross-sectional study.
复制标题
DOI：
10.1186/s12954-023-00755-4
复制
发表时间：
2023-02-28
影响因子：
4.4
通讯作者：
Kral, Alex H.
中科院分区：
文献类型：
--
作者：
Lambdin, Barrot H.;Wenger, Lynn;Bluthenthal, Ricky;Bartholomew, Tyler S.;Tookes, Hansel E.;LaKosky, Paul;O'Neill, Savannah;Kral, Alex H.
纳洛酮是一种可以快速逆转阿片类药物过量的药物。注射器服务计划（SSP）是以社区为基础的预防计划，在美国提供一系列基于证据的干预措施，包括纳洛酮分配。SSP的属性使他们成为纳洛酮分配的理想环境-他们有工作人员和交付模式，旨在达到使用药物的人。我们评估了SSP的外部和内部设置因素与美国纳洛酮分布相关。我们调查了2019年北美注射器交换网络已知的美国SSP。使用探索，准备，实施和维护框架，我们评估了与纳洛酮在SSP（n = 263或77%的SSP）之间分布相关的内部和外部背景因素。我们利用负二项回归来评估哪些因素与分配的纳洛酮剂量和接受纳洛酮的人数相关。SSP报告说，去年向230，506人分发了710，232剂纳洛酮。至于外部环境，位于社区支持水平高的地区的SSP具有较高的纳洛酮分布水平（aIRR = 3.07; 95%置信区间（CI）：2.09-4.51; p < 0.001）和110%（p = 0.022）在过去12个月内接受纳洛酮的患者比例较高（aIRR = 2.10; 95% CI 1.46-3.02; p < 0.001）。SSP的法律的地位和需求水平与纳洛酮分布无显著相关性。关于内部设置，具有主动再填充系统的SSP（aIRR = 2.08; 95% CI 1.27-3.41; p = 0.004），分发天数更多（aIRR = 1.09/天; 95% CI 1.06-1.11; p < 0.001）和更老的项目（aIRR = 1.06/年; 95% CI 1.02-1.11; p = 0.004）与纳洛酮分布水平较高相关。此外，具有主动再填充系统的SSP（aIRR = 2.23; 95% CI 1.38-3.58; p = 0.001）;分发天数更多（aIRR = 1.04; 95% CI 1.02-1.07; p < 0.001）和更早的项目（aIRR = 1.11; 95% CI 1.05-1.17; p < 0.001）与接受纳洛酮的人数更多相关。我们确定了与纳洛酮分布相关的SSP的外部和内部设置因素。至关重要的是确保SSP有足够的资源来建立社区对服务的支持，并开发服务提供模式，最大限度地提高纳洛酮的分配，以解决国家的阿片类药物过量危机。
Naloxone is a medication that can quickly reverse an opioid overdose. Syringe service programs (SSPs) are community-based prevention programs that provide a range of evidence-based interventions in the USA, including naloxone distribution. Attributes of SSPs make them ideal settings for naloxone distribution—they have staff and delivery models that are designed to reach people who use drugs where they are. We assessed which outer and inner setting factors of SSPs were associated with naloxone distribution in the USA. We surveyed SSPs in the USA known to the North American Syringe Exchange Network in 2019. Using the exploration, preparation, implementation and maintenance framework, we assessed inner and outer contextual factors associated with naloxone distribution among SSPs (n = 263 or 77% of SSPs). We utilized negative binomial regression to assess which factors were associated with the number of naloxone doses distributed and people receiving naloxone. SSPs reported distributing 710,232 naloxone doses to 230,506 people in the prior year. Regarding outer setting, SSPs located in areas with high levels of community support had a higher level of naloxone distribution (aIRR = 3.07; 95% confidence interval (CI): 2.09–4.51; p < 0.001) and 110% (p = 0.022) higher rate of people receiving naloxone (aIRR = 2.10; 95% CI 1.46–3.02; p < 0.001) in the past 12 months. The legal status of SSPs and the level of need was not significantly associated with naloxone distribution. Regarding inner setting, SSPs with proactive refill systems (aIRR = 2.08; 95% CI 1.27–3.41; p = 0.004), greater number of distribution days (aIRR = 1.09 per day; 95% CI 1.06–1.11; p < 0.001) and older programs (aIRR = 1.06 per year; 95% CI 1.02–1.11; p = 0.004) were associated with higher levels of naloxone distribution. Also, SSPs with proactive refill systems (aIRR = 2.23; 95% CI 1.38–3.58; p = 0.001); greater number of distribution days (aIRR = 1.04; 95% CI 1.02–1.07; p < 0.001) and older programs (aIRR = 1.11; 95% CI 1.05–1.17; p < 0.001) were associated with a higher number of people receiving naloxone. We identified outer and inner setting factors of SSPs that were associated with greater naloxone distribution. It is critical to ensure SSPs are adequately resourced to build community support for services and develop service delivery models that maximize naloxone distribution to address the nation’s opioid overdose crisis.
登录
查看更多内容
DOI：
10.1111/add.13265
发表时间：
2016-05
期刊：
Addiction (Abingdon, England)
影响因子：
--
作者：
Bird SM;McAuley A;Perry S;Hunter C
通讯作者：
Hunter C
影响因子：
3.9
作者：
Heinzerling, Keith G.;Kral, Alex H.;Bluthenthal, Ricky N.
通讯作者：
Bluthenthal, Ricky N.
影响因子：
12.7
作者：
Davis, Corey S.;Ruiz, Sarah;Walley, Alexander Y.
通讯作者：
Walley, Alexander Y.
影响因子：
33.9
作者：
Rudd, Rose A.;Seth, Puja;Scholl, Lawrence
通讯作者：
Scholl, Lawrence
影响因子：
4.2
作者：
Kinnard, Elizabeth N.;Bluthenthal, Ricky N.;Lambdin, Barrot H.
通讯作者：
Lambdin, Barrot H.