提供者对用于治疗阿片类药物使用障碍的缓释丁丙诺啡的看法。

IF 4.2 3区 医学 Q1 SUBSTANCE ABUSE Journal of Addiction Medicine Pub Date : 2024-09-01 Epub Date: 2024-05-31 DOI:10.1097/ADM.0000000000001320
India A Reddy, Carolyn M Audet, Thomas J Reese, Grayson Peek, David Marcovitz
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引用次数: 0

摘要

目标:阿片类药物危机的持续存在和合成芬太尼的扩散提高了对新型给药机制治疗阿片类药物使用障碍的需求,其中包括注射用缓释丁丙诺啡(buprenorphine-ER)。本研究旨在了解医疗服务提供者在开具丁丙诺啡处方时遇到的障碍,以便采取有针对性的策略,改善这种新型制剂对患者的治疗效果:我们使用改编自实施研究综合框架(CFIR)的访谈模板,对一家戒毒门诊的 20 名医疗服务提供者进行了结构化焦点小组访谈,共分 4 次进行,以评估医疗服务提供者对丁丙诺啡-ER 的看法。我们确定了 94 条独特的意见,并使用标准化的 CFIR 结构对其进行了演绎编码:结果:医疗服务提供者对使用丁丙诺啡-ER的接受程度和信心参差不齐。尽管医疗服务提供者可以发现注射制剂与丁丙诺啡舌下含服相比有许多理论上的优势,但许多人表示由于缺乏经验、病人的负面经历、不确定病人是否适合、成本和后勤限制等原因而对使用丁丙诺啡-ER持保留态度:结论:提供者对丁丙诺啡-ER 的担忧可能会限制其使用。结论:医疗服务提供者对丁丙诺啡-ER 的顾虑可能会限制其使用。通过加强教育、研究和后勤支持,可以减轻一些顾虑。鉴于丁丙诺啡-ER 可能带来的益处,未来的研究应针对实施障碍,部分研究应基于这些发现所提出的假设。
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Provider Perceptions Toward Extended-Release Buprenorphine for Treatment of Opioid Use Disorder.

Objectives: The persistence of the opioid crisis and the proliferation of synthetic fentanyl have heightened the demand for the implementation of novel delivery mechanisms of pharmacotherapy for the treatment of opioid use disorder, including injectable extended-release buprenorphine (buprenorphine-ER). The purpose of this study was to understand provider-level barriers to prescribing buprenorphine in order to facilitate targeted strategies to improve implementation for patients who would benefit from this novel formulation.

Methods: Using an interview template adapted from the Consolidated Framework for Implementation Research (CFIR), we conducted structured focus group interviews with 20 providers in an outpatient addiction clinic across 4 sessions to assess providers' perceptions of buprenorphine-ER. Ninety-four unique comments were identified and deductively coded using standardized CFIR constructs.

Results: Providers expressed mixed receptivity and confidence in using buprenorphine-ER. Although providers could identify a number of theoretical advantages to the injectable formulation over sublingual buprenorphine, many expressed reservations about using it due to inexperience, negative patient experiences, uncertainties about patient candidacy, cost, and logistical constraints.

Conclusions: Provider concerns about buprenorphine-ER may limit utilization. Some concerns may be mitigated through improved education, research, and logistical support. Given the putative benefits of buprenorphine-ER, future research should target barriers to implementation, in part based on hypotheses generated by these findings.

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来源期刊
Journal of Addiction Medicine
Journal of Addiction Medicine 医学-药物滥用
CiteScore
6.10
自引率
9.10%
发文量
260
审稿时长
>12 weeks
期刊介绍: The mission of Journal of Addiction Medicine, the official peer-reviewed journal of the American Society of Addiction Medicine, is to promote excellence in the practice of addiction medicine and in clinical research as well as to support Addiction Medicine as a mainstream medical sub-specialty. Under the guidance of an esteemed Editorial Board, peer-reviewed articles published in the Journal focus on developments in addiction medicine as well as on treatment innovations and ethical, economic, forensic, and social topics including: •addiction and substance use in pregnancy •adolescent addiction and at-risk use •the drug-exposed neonate •pharmacology •all psychoactive substances relevant to addiction, including alcohol, nicotine, caffeine, marijuana, opioids, stimulants and other prescription and illicit substances •diagnosis •neuroimaging techniques •treatment of special populations •treatment, early intervention and prevention of alcohol and drug use disorders •methodological issues in addiction research •pain and addiction, prescription drug use disorder •co-occurring addiction, medical and psychiatric disorders •pathological gambling disorder, sexual and other behavioral addictions •pathophysiology of addiction •behavioral and pharmacological treatments •issues in graduate medical education •recovery •health services delivery •ethical, legal and liability issues in addiction medicine practice •drug testing •self- and mutual-help.
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