识别提供方在实施阿片类药物减低危害方法时遇到的障碍:初步叙述性评论。

IF 1.7 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES Inquiry-The Journal of Health Care Organization Provision and Financing Pub Date : 2024-01-01 DOI:10.1177/00469580241276144
Stacie A Dee, Ketrice-Ann Delonnay, Destiny Bernard, Fahimir Jean-Baptiste
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引用次数: 0

摘要

根据美国疾病控制和预防中心的数据,阿片类药物的流行仍然是美国的一个主要问题,2021 年有超过 8 万人死于阿片类药物。这场公共卫生危机继续影响着全国各地的社区,凸显了干预的必要性,也反映出美国通过刑事定罪来减少阿片类药物使用的禁药尝试已经失败。事实证明,减少危害的方法在预防不良健康后果和促进阿片类药物使用障碍患者的整体福祉方面是有效的。然而,在医疗服务提供者的普遍实施方面仍存在巨大差距。本综述评估了 PICOT 问题:医疗服务提供者在对 18 岁及以上患有或未患有阿片类药物使用障碍的成年人实施循证减低伤害方法时存在哪些障碍?我们使用关键词在数据库中进行了文献检索,关键词包括"医疗服务提供者"、"医生"、"药剂师"、"减低伤害"、"减低伤害计划"、"纳洛酮"、"丁丙诺啡-纳洛酮诱导"、"美沙酮"、"纳洛酮带回家工具包"、"羞辱"、"障碍"、"负面看法"、"拒绝"。纳入标准的重点是确定提供者的障碍,特别是有关阿片类药物使用的障碍。.审查显示,提供者在防止减少伤害方面存在三大障碍:污名化、缺乏教育和知识,以及缺乏获得长期管理资源的途径。认识到提供者中存在的这些障碍可以帮助机构制定有针对性的干预措施来克服这些障碍,从而广泛采用减少阿片类药物伤害的方法。研究结果对作者检索时的现有证据进行了初步的叙述性回顾,为实践、政策和未来研究提供了参考。
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Identifying Provider Barriers to the Implementation of Opioid Harm Reduction Methods: An Initial Narrative Review.

According to the Centers for Disease Control and Prevention, the opioid epidemic remains a major issue in the United States, with over 80,000 deaths attributed to opioids in 2021. This public health crisis continues to impact communities across the country, highlighting the need for intervention and reflecting the nation's failed attempts at prohibition through criminalization to reduce opioid use. Harm reduction methodshave proven to be effective in preventing adverse health outcomes and promoting the overall well-being of individuals with opioid use disorders. However, significant gaps remain in the universal implementation by healthcare providers. This review evaluated the PICOT question: What barriers exist among providers in implementing evidence-based harm reduction methods for adults aged 18 years and older, with and without opioid use disorders? A literature search was conducted across databases using key words which included: "Health care provider," "Physician," "Pharmacist," "Harm reduction," "Harm reduction programs," "Naloxone," "Buprenorphine-naloxone induction," "Methadone," "Naloxone take home kits," "Stigma," "Barriers," "Negative perception," "Refusal." The inclusion criteria focused on identifying provider barriers, specifically regarding opioid use. . The review revealed 3 major barriers that exist among providers to prevent harm reduction: stigma, lack of education and knowledge, and lack of access to resources for long-term management. Recognizing these barriers among providers can help organizations develop targeted interventions to overcome them, leading to widespread adoption of opioid harm reduction methods. The results provide an initial narrative review of the current evidence at the time of the authors search to inform practice, policy, and future research.

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来源期刊
CiteScore
2.50
自引率
0.00%
发文量
192
审稿时长
>12 weeks
期刊介绍: INQUIRY is a peer-reviewed open access journal whose msision is to to improve health by sharing research spanning health care, including public health, health services, and health policy.
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