Toward safer opioid prescribing: effects of the TOWER intervention on HIV care providers.
Toward safer opioid prescribing: effects of the TOWER intervention on HIV care providers.
复制标题
实现更安全的阿片类药物处方：TOWER 干预对艾滋病毒护理人员的影响。
DOI：
10.1080/09540121.2021.1887444
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发表时间：
2022
期刊：
影响因子：
1.7
通讯作者：
Robinson-Papp,Jessica
中科院分区：
文献类型：
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作者：
Scherer,Maya;Kamler,Alexandra;Weiss,Linda;George,Mary-Catherine;Cedillo,Gabriela;Cárdenas,Luisa;Daniel,Sheaba;DeGarmo,Ellie;Leavell,Yaowaree;Lin,Tiffany;Robinson-Papp,Jessica
阿片类药物使用障碍和相关死亡的发生率仍然高得惊人。应对这一流行病的措施包括减少阿片类药物处方，部分由疾病控制中心阿片类药物处方指南（CDCG）指导。虽然减少了过度处方，但这些措施也导致一些稳定的阿片类药物治疗慢性疼痛患者的可及性减少和不良结局。TOWard Safer阿片类药物处方（TOWER）干预旨在支持艾滋病毒初级保健提供者使用CDCG以及关于安全阿片类药物处方的决策和患者-提供者沟通。11名HIV初级保健提供者和40名患者被随机分为干预组和对照组。分析了21名患者就诊的成绩单，重点是阿片类药物和疼痛相关的沟通。这项研究的结果表明，在与TOWER干预组的提供者进行的访问中，与CDCG的一致性更高。然而，对照组访问在几个关键领域与指南建议明显一致。干预组和对照组访视之间观察到的差异证明了干预的优势，以及需要做额外工作以确保处方和沟通与CDCG一致的领域。
Rates of opioid use disorder and associated deaths remain alarmingly high. Measures to address the epidemic have included reductions in opioid prescribing, in part guided by the Centers for Disease Control Opioid Prescribing Guideline (CDCG). While reductions in over-prescribing have occurred, these measures have also resulted in decreased access and adverse outcomes for some stable opioid-treated chronic pain patients. The TOWard SafER Opioid Prescribing (TOWER) intervention was designed to support HIV primary care providers in use of the CDCG and in decision-making and patient–provider communication regarding safe opioid prescribing. Eleven HIV primary care providers and 40 of their patients were randomized into intervention and control groups. Transcripts from 21 patient visits were analyzed, focusing on opioid and pain-related communications. Findings from this research indicate greater alignment with the CDCG among visits carried out with providers in the TOWER intervention group. However, control group visits were notably consistent with guideline recommendations in several key areas. Differences observed between the intervention and control group visits demonstrate intervention strengths, as well as areas where additional work needs to be done to ensure prescribing and communication consistent with the CDCG.