Opioid overdose prevention education for medical students: Adopting harm reduction into mandatory clerkship curricula
Opioid overdose prevention education for medical students: Adopting harm reduction into mandatory clerkship curricula
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DOI：
10.1080/08897077.2019.1621241
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发表时间：
2019-06-18
期刊：
影响因子：
3.5
通讯作者：
Capurso, Noah A.
中科院分区：
文献类型：
--
作者：
Oldfield, Benjamin J.;Tetrault, Jeanette M.;Capurso, Noah A.
背景：阿片类药物过量死亡构成美国的公共卫生危机。减少阿片类药物相关危害的策略未得到充分利用，部分原因是临床医生对减少危害理论了解甚少，而且开纳洛酮的准备有限。需要采取教育干预措施来提高医学生对阿片类药物过量的认识和态度，并做好应对阿片类药物过量的准备。方法：根据退伍军人事务部的过量教育和纳洛酮分配 (OEND) 计划和叙事医学的信息，我们为实习医学生制定并领导了一个关于减少伤害的强制性研讨会。我们使用经过验证的量表，在研讨会之前和之后 6 周评估了学生对阿片类药物过量的知识和态度以及应对阿片类药物过量的准备情况。结果：2017 年 2 月至 12 月期间，75 名参与学生中，55 名 (73%) 完成了研讨会前调查，38 名 (51%) 完成了研讨会前和研讨会后调查。在基线时，40 名 (73%) 的患者在过去 6 周内遇到过使用阿片类药物的风险，但只有 11 名 (20%) 回忆起他们的团队开纳洛酮处方以预防过量用药。在完成两项调查的受访者中，预防用药过量的知识和准备情况显示出较大改善（分别为 Cohen's d = 0.85，P < .001；Cohen's d = 1.24，P < .001），态度则显示出适度改善（Cohen's d = 0.32，P = .04）。讨论：基于减害理论的教育干预可以增加学生对阿片类药物过量的了解和态度，并做好应对的准备。
Background: Opioid overdose deaths constitute a public health crisis in the United States. Strategies for reducing opioid-related harm are underutilized due in part to clinicians' low knowledge about harm reduction theory and limited preparedness to prescribe naloxone. Educational interventions are needed to improve knowledge and attitudes about, and preparedness to address, opioid overdoses among medical students. Methods: Informed by the Department of Veterans Affairs' Overdose Education and Naloxone Distribution (OEND) program and narrative medicine, we developed and led a mandatory workshop on harm reduction for clerkship medical students. Using validated scales, we assessed students' knowledge and attitudes about, and preparedness to address, opioid overdoses before the workshop and 6 weeks after. Results: Of 75 participating students from February through December 2017, 55 (73%) completed pre-workshop and 38 (51%) completed both pre- and post-workshop surveys. At baseline, 40 (73%) encountered patients with perceived at-risk opioid use in the previous 6 weeks, but only 11 (20%) recalled their teams prescribing naloxone for overdose prevention. Among those completing both surveys, knowledge about and preparedness to prevent overdose showed large improvement (Cohen's d = 0.85, P < .001; Cohen's d = 1.24, P < .001, respectively) and attitudes showed moderate improvement (Cohen's d = 0.32, P = .04). Discussion: Educational interventions grounded in harm reduction theory can increase students' knowledge and attitudes about, and preparedness to address, opioid overdoses.