Physician practices to prevent ADHD stimulant diversion and misuse
Physician practices to prevent ADHD stimulant diversion and misuse
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DOI：
10.1016/j.jsat.2016.12.003
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发表时间：
2017-03-01
影响因子：
3.9
通讯作者：
Adesman, Andrew
中科院分区：
文献类型：
--
作者：
Colaneri, Natalie;Keim, Sarah;Adesman, Andrew
背景：最近的研究报告，大量的青少年滥用和转移处方兴奋剂。作为这些药物的处方者，医生有一个独特的机会来帮助防止这些药物的不当使用和非法分发。本研究评估在何种程度上，医生采用预防措施与他们的青少年患者ADHD和他们的看法，这些practices.Methods的有效性：问卷调查，并邮寄给儿童和青少年精神科医生，儿童神经学家，和发育行为儿科医生在美国。描述性统计进行了最后的样本（n = 828;响应率= 18.4%），作为回归，以确定差异时，医生分组的亚专业和处方volume.Results：许多医生“从不”或“很少”使用药物合同（85.2%）或分发印刷材料（81.0%），ADHD患者时，他们怀疑误用和/或转移。46.2%不“经常”指药物咨询或药物滥用治疗时，他们怀疑兴奋剂滥用和/或转移的病人。医生答复者在怀疑兴奋剂滥用和/或转移时至少“经常”采取的主要预防措施是开长效而不是立即释放的兴奋剂（79.2%）和开非兴奋剂（71.9%）。71.4%的受访者认为开非兴奋剂处方在防止滥用和转移方面“非常有效”。相反，分别有53.4%和31.5%的医生认为使用药物合同和分发印刷材料“不太可能有效”。“与其他专科医生相比，儿童和青少年精神科医生更有可能实施某些预防措施。许多回应的医生不定期实施的做法，可能会防止兴奋剂滥用，大多数人认为大多数预防措施不是很effective.Conclusion：医生应该承担更大的责任，在预防兴奋剂滥用和转移，实施预防措施，往往与他们的青少年ADHD患者。关于这些发现的普遍性，必须指出的是，样本仅限于儿科专科医生，可能受到选择偏倚和反应偏倚的影响。必须开展进一步研究，以更好地了解医生对兴奋剂风险和益处的看法，并确定预防兴奋剂滥用和转移的最佳做法。(C)2016 Elsevier Inc. All rights reserved.
Background: Recent studies report that a significant number of adolescents misuse and divert prescription stimulants. As prescribers of these medications, physicians have a unique opportunity to help prevent the improper use and unlawful distribution of these medications. This study evaluates the extent to which physicians employ prevention practices with their adolescent patients with ADHD and their perceptions of the effectiveness of these practices.Methods: A questionnaire was developed and mailed to child and adolescent psychiatrists, child neurologists, and developmental-behavioral pediatricians in the US. Descriptive statistics were performed on the final sample (n = 828; response rate = 18.4%), as were regressions to identify differences when physicians were grouped by subspecialty and prescribing volume.Results: Many physicians "never" or "rarely" use medication contracts (85.2%) or distribute print materials (81.0%) to patients with ADHD when they suspect misuse and/or diversion. 46.2% do not "often" refer for drug counseling or substance abuse treatment when they suspect a patient of stimulant misuse and/or diversion. The leading prevention practices implemented by physician respondents at least "often" when they suspect stimulant misuse and/or diversion are prescribing long-acting instead of immediate-release stimulants (79.2%) and prescribing non-stimulants (71.9%). 71.4% of respondents believed prescribing non-stimulants is "very effective" at preventing misuse and diversion. Conversely, 53.4% and 31.5% of physicians, respectively, labeled using a medication contract and distributing print materials as "not likely effective." Child and adolescent psychiatrists were more likely to implement certain prevention practices compared to other subspecialists. Many responding physicians do not regularly implement practices that may prevent stimulant misuse, and the majority thinks most prevention practices are not very effective.Conclusion: Physicians should assume greater responsibility in the prevention of stimulant misuse and diversion by implementing prevention practices more often with their adolescent patients with ADHD. With respect to the generalizability of these findings, it must be noted that the sample was limited to pediatric subspecialists and may be influenced by selection bias and response bias. Further research must be performed to better understand physicians' views of the risks and benefits of stimulants and to ascertain best practices for the prevention of stimulant misuse and diversion. (C) 2016 Elsevier Inc. All rights reserved.