Patient Willingness to Dispose of Leftover Opioids After Surgery: A Mixed Methods Study.
Patient Willingness to Dispose of Leftover Opioids After Surgery: A Mixed Methods Study.
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DOI：
10.1097/as9.0000000000000223
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发表时间：
2022-12
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我们研究了便利性和经济激励如何影响患者在手术后处理剩余处方阿片类药物的意愿。我们还确定了处置的其他障碍和促进因素。在美国，高达70%的外科手术患者服用阿片类药物，高达92%的患者会有剩余的药片。大多数人不处理剩余的阿片类药物，增加了阿片类药物相关伤害的风险。目前促进类阿片处置的干预措施取得的成功好坏参半。我们进行了一项混合方法的研究，使用标准的赌博调查和半结构化访谈。参与者估计了在16种不同便利性（<5分钟、15分钟、30分钟和60分钟的时间要求）和财政激励（0美元、5美元、25美元、50美元）的情况下的处置意愿。我们估计处置的可能性，使用多变量混合效应修改泊松回归模型。半结构化访谈探讨了便利性、经济激励和其他障碍和促进因素如何影响处置决定。55名参与者接受了调查，42人接受了采访。大多数人愿意在所需时间<15分钟时处理。如果这个过程需要60分钟，很少有人愿意处理，尽管50美元的经济激励将利率从9%提高到36%。对未来疼痛、阿片类药物稀缺、娱乐使用、家庭安全、道德信仰、成瘾、盗窃和环境危害的焦虑也影响了决策。促进阿片类药物处置的干预措施应侧重于便利性，但有选择地使用财政激励措施可能是有效的。针对个别障碍和便利因素采取干预措施也可以提高处置率。
We examined how convenience and financial incentives influence patient willingness to dispose of leftover prescription opioids after surgery. We also identified additional barriers and facilitators to disposal. In the United States, up to 70% of surgical patients are prescribed opioids and up to 92% will have leftover tablets. Most do not dispose of leftover opioids, increasing the risk for opioid-related harm. Current interventions promoting opioid disposal have shown mixed success. We conducted a mixed methods study using a standard gamble survey and semi-structured interviews. Participants estimated willingness to dispose in 16 scenarios with varying convenience (time requirements of <5, 15, 30, and 60 minutes) and financial incentives ($0, $5, $25, $50). We estimated the likelihood of disposal using a multivariable mixed effects modified Poisson regression model. Semi-structured interviews explored how convenience, financial incentives, and other barriers and facilitators influenced decisions to dispose. Fifty-five participants were surveyed and 42 were interviewed. Most were willing to dispose when the time required was <15 minutes. Few were willing to dispose if the process required 60 minutes, although a $50 financial incentive increased rates from 9% to 36%. Anxiety about future pain, opioid scarcity, recreational use, family safety, moral beliefs, addiction, theft, and environmental harm also influenced decision-making. Interventions promoting opioid disposal should focus on convenience, but the selective use of financial incentives can be effective. Tailoring interventions to individual barriers and facilitators could also increase disposal rates.