Implementation of academic detailing for pharmacists on opioid use disorder and harm reduction
Implementation of academic detailing for pharmacists on opioid use disorder and harm reduction
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DOI：
10.1016/j.japh.2021.09.012
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发表时间：
2022-01-04
影响因子：
2.1
通讯作者：
Love, Raymond C.
中科院分区：
文献类型：
--
作者：
DiPaula, Bethany A.;Cooke, Catherine E.;Love, Raymond C.
背景：美国正在经历阿片类药物危机，大流行大大恶化了这一危机。药剂师通过减少伤害的努力和治疗阿片类药物使用障碍(MOUD)的药物，在扩大获得护理方面发挥了关键作用，但缺乏必要的教育和资源。学术细节是一种一对一的技术，可以有效地解决教育差距。目标：目的是评估需求并装备药房工作人员，以解决物质使用障碍(SUD)患者的健康问题。实践描述：社区药剂师为SUD患者提供持续护理。实践创新：根据需求评估结果，设计学术细节计划，为社区药房提供教育和资源。该项目旨在评估目前的做法和需求，并解决药剂师在管理阿片类药物使用障碍(OUD)和/或有过量用药风险(OD)的患者方面的技能。访问计划在高危地区进行。提供辅导和资料。评估方法：详细人员完成访问报告。离散变量使用描述性统计进行报告。离散变量间的关联性用卡方检验或Fisher‘s精确检验进行检验。根据州法律，库存最多的是纳洛酮(86.8%)、穆德(94.9%)和会出售注射器(%)。57%的药店提供所有这些服务。然而，还需要更多的教育和资源。只有27.9%的人有纳洛酮标志和/或讲义；22.1%的人有补充材料；25%的人有转诊信息。当被要求解释障碍时，经常被提及的主题包括提供资源/帮助、经济问题、耻辱和交通。结论：药剂师经常照顾有吸毒风险并被诊断为OUD的患者。学术细节是一种广受欢迎的策略，用于传播教育和材料，同时收集关于药剂师需求和障碍的信息。然而，仍有扩大服务的空间和改善护理的机会。进一步的努力应包括持续的培训和获取具有视觉提示的材料，以及转介和节省费用的信息。(C)2022年美国药剂师协会(R)。爱思唯尔公司出版，版权所有。
Background: The United States is experiencing an opioid crisis, substantially worsened by the pandemic. Pharmacists play a critical role in expanding access to care through harm reduction efforts and medications to treat opioid use disorder (mOUD), yet lack necessary education and resources. Academic detailing is a one-on-one technique, which can effectively address educational gaps.Objective: The purpose was to assess needs and equip pharmacy staff to address the health of people with substance use disorders (SUD).Practice description: Community pharmacists provide ongoing care for patients with SUD.Practice innovation: Based on needs' assessment findings, an academic detailing program was designed to provide education and resources for community pharmacies. The project sought to assess current practice and needs and address pharmacists' skills in managing patients with opioid use disorder (OUD) and/or at risk for overdose (OD). Visits were scheduled in high-risk regions. Coaching and materials were provided.Evaluation methods: Detailers completed visits reports. Discrete variables were reported using descriptive statistics. Associations between discrete variables were detected with Chi-square or Fisher's exact test.Results: Detailers visited 136 pharmacies. Most stocked naloxone (86.8%), mOUD (94.9%) and would sell syringes (64%) per state law. Fifty-seven percent of pharmacies provided all of these services. However, additional education and resources were needed. Only 27.9% had naloxone signage and/or handouts; 22.1% had supplemental materials; and 25% had referral information. When asked to explain barriers, frequently cited themes included providing resources/ help, financial issues, stigma, and transportation.Conclusion: Pharmacists routinely care for patients at risk for OD and diagnosed with OUD. Academic detailing is a well-received strategy to disseminate education and materials, while gathering information about pharmacist needs and barriers. However, there remains room for expansion of services and opportunities for improved care. Further efforts should incorporate ongoing training and access to materials with visual cues, as well as referral and cost savings information. (C) 2022 American Pharmacists Association (R). Published by Elsevier Inc. All rights reserved.