在有毒药物紧急事件中开具更安全供应处方的途径和障碍:对加拿大不列颠哥伦比亚省实施情况的混合方法研究。

IF 3 3区 医学 Q2 SUBSTANCE ABUSE
Karen A Urbanoski,Thea van Roode,Marion Selfridge,Katherine C Hogan,James Fraser,Kurt Lock,Phoenix Beck McGreevy,Charlene Burmeister,Brittany Barker,Amanda Slaunwhite,Bohdan Nosyk,Bernadette Pauly
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引用次数: 0

摘要

背景 2020 年 3 月,加拿大不列颠哥伦比亚省推出了更安全的处方药供应,其中包括分发医药级替代品,以取代不受管制的有毒药物供应。先前的研究表明,这种方法对用药过量死亡率有积极影响,但对药物使用者的影响有限。本研究的目标是:(1)确定药物使用者在获得更安全的供应处方时遇到的障碍;(2)确定有处方者和无处方者之间以及城市和农村环境之间遇到的障碍是否不同以及如何不同。结果有处方的参与者更有可能居住在大城市中心,而不是中小城市中心和农村地区(78.5% 对 65.8%,标准化平均差异 = 0.286)。没有处方的参与者更有可能报告一系列结构性、人际关系和健康相关障碍(与有处方的参与者相比)。在访谈中,参与者将障碍的经历与污名化和刑事犯罪、服务供应不足、缺乏信息和处方医生、无法获得所需的东西,以及源于个人情况的焦虑、担忧和疑虑联系起来。在存在特定类型的障碍方面,大型城市中心与中型/小型中心和农村地区之间没有明显差异。在实施应对当前有毒药物紧急状况的措施时,需要注意促进公平和消除系统性障碍。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Access and barriers to safer supply prescribing during a toxic drug emergency: a mixed methods study of implementation in British Columbia, Canada.
BACKGROUND In March 2020, British Columbia, Canada, introduced prescribed safer supply involving the distribution of pharmaceutical grade alternatives to the unregulated toxic drug supply. Prior research has demonstrated positive impacts on overdose mortality, but with limited reach to people who use substances. Objectives of this study were to (1) identify barriers to accessing safer supply prescribing among people who use substances; and (2) determine whether and how barriers differed between people with and without prescriptions, and between urban and rural settings. METHODS We conducted a participatory mixed-methods study guided by the Consolidated Framework for Implementation Research. Participants (≥ 19 years old) had received a safer supply prescription or were seeking one (survey n = 353; interviews n = 54). RESULTS Participants who had a prescription were more likely to be living in a large urban centre, compared to medium/smaller centres and rural areas (78.5% vs. 65.8%, standardized mean difference = 0.286). Participants who did not have a prescription were more likely to report an array of structural, interpersonal, and health-related barriers (compared to those who had a prescription). In interviews, participants linked experiences of barriers to stigma and criminalization, low availability of services, lack of information and prescribers, not being able to get what they need, and anxieties, worries and doubts stemming from personal circumstances. There were no notable differences between large urban centres and medium/smaller centres and rural areas in the presence of specific types of barriers. CONCLUSIONS Findings demonstrate restricted access to safer supply prescribing outside of large urban centres and provide future targets for enhancing implementation. Attention is needed to promote equity and counter systemic barriers in the implementation of responses to the ongoing toxic drug emergency.
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来源期刊
CiteScore
5.20
自引率
0.00%
发文量
73
审稿时长
19 weeks
期刊介绍: Substance Abuse Treatment, Prevention, and Policy is an open access, peer-reviewed journal that encompasses research concerning substance abuse, with a focus on policy issues. The journal aims to provide an environment for the exchange of ideas, new research, consensus papers, and critical reviews, to bridge the established fields that share a mutual goal of reducing the harms from substance use. These fields include: legislation pertaining to substance use; correctional supervision of people with substance use disorder; medical treatment and screening; mental health services; research; and evaluation of substance use disorder programs.
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