A qualitative evaluation of a fentanyl patch safer supply program in Vancouver, Canada

IF 4.4 2区 医学 Q1 SUBSTANCE ABUSE
Alexa Norton , Andrew Ivsins , Elizabeth Holliday , Christy Sutherland , Thomas Kerr , Mary Clare Kennedy
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引用次数: 0

Abstract

Background

The ongoing overdose crisis in Canada has prompted efforts to increase access to a “safer supply” of prescribed alternatives to the unregulated drug supply. While safer supply programs predominantly distribute hydromorphone tablets, the Safer Alternatives for Emergency Response (SAFER) program in Vancouver, Canada offers a range of prescribed alternatives, including fentanyl patches. However, little is known about the effectiveness of fentanyl patches as safer supply. Drawing on the perspectives and experiences of program participants, we sought to qualitatively evaluate the effectiveness of the SAFER fentanyl patch program in meeting its intended aims, including reducing risk of overdose by decreasing reliance on the unregulated drug supply.

Methods

As part of a larger mixed-methods evaluation of SAFER, semi-structured qualitative interviews were conducted with 17 fentanyl patch program participants between February 2022 and April 2023. Thematic analysis of interview data focused on program engagement, experiences, impacts, and challenges.

Results

The flexible program structure, including lack of need for daily dispensation, the extended missed dose protocol, and community pharmacy patch distribution fostered engagement and enhanced autonomy. Improved management of withdrawal symptoms and cravings due to steady transdermal dosing led to reduced unregulated drug use and overdose risk. Participants also experienced economic benefits and improvements in overall health and quality of life. However, skin irritation and patch adhesion issues were key barriers to program retention.

Conclusion

Our findings demonstrate the value of including fentanyl patch safer supply in the substance use continuum of care and offer insights for innovations in delivery of this intervention.

对加拿大温哥华芬太尼贴片安全供应计划的定性评估
背景加拿大持续的用药过量危机促使人们努力增加获得 "更安全供应 "的处方替代品的机会,以取代不受管制的药物供应。虽然安全供应计划主要分发氢吗啡酮片剂,但加拿大温哥华的 "应急反应安全替代品(SAFER)"计划提供了一系列处方替代品,包括芬太尼贴片。然而,人们对芬太尼贴片作为更安全供应品的有效性知之甚少。作为 SAFER 大型混合方法评估的一部分,我们在 2022 年 2 月至 2023 年 4 月期间对 17 名芬太尼贴片项目参与者进行了半结构化定性访谈。结果灵活的项目结构,包括无需每日配药、延长漏服协议和社区药房贴片分发,促进了参与并增强了自主性。稳定的透皮给药改善了对戒断症状和渴求的控制,从而减少了不规范用药和用药过量的风险。参与者还获得了经济收益,并改善了整体健康和生活质量。结论:我们的研究结果表明,将芬太尼贴片更安全的供应纳入药物使用的连续性护理中具有重要价值,并为这种干预措施的创新提供了启示。
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来源期刊
CiteScore
7.80
自引率
11.40%
发文量
307
审稿时长
62 days
期刊介绍: The International Journal of Drug Policy provides a forum for the dissemination of current research, reviews, debate, and critical analysis on drug use and drug policy in a global context. It seeks to publish material on the social, political, legal, and health contexts of psychoactive substance use, both licit and illicit. The journal is particularly concerned to explore the effects of drug policy and practice on drug-using behaviour and its health and social consequences. It is the policy of the journal to represent a wide range of material on drug-related matters from around the world.
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