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处方药监测项目的设计与功能:一项定性分析

Prescription drug monitoring program design and function: A qualitative analysis.

作者信息

Rutkow Lainie, Smith Katherine C, Lai Alden Yuanhong, Vernick Jon S, Davis Corey S, Alexander G Caleb

机构信息

Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD, 21205, USA.

Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD, 21205, USA.

出版信息

Drug Alcohol Depend. 2017 Nov 1;180:395-400. doi: 10.1016/j.drugalcdep.2017.08.040. Epub 2017 Sep 28.

Abstract

BACKGROUND

Opioid-related overdose deaths are a major public health challenge. Forty-nine states have implemented Prescription Drug Monitoring Programs (PDMPs) that collect information about individuals' prescription medications. Little is known about state governments' implementation of PDMPs. We conducted semi-structured interviews with PDMP staff, law enforcement officials, and administrative agency employees to learn about their attitudes and experiences with PDMPs.

METHODS

From May 2015 to June 2016, we conducted 37 semi-structured interviews with state actors in four states. Questions focused on interviewees' perceptions about PDMP goals, home agency characteristics, and future PDMP initiatives. States were selected purposively. Interviewees were identified through purposive and snowball sampling.

RESULTS

Interviewees identified key PDMP goals as: improve patient treatment decisions; influence prescribing practices; assist in the identification of "doctor shoppers"; and serve as a tool for law enforcement. Interviewees identified the following characteristics as key for a PDMP's home agency: regulatory and enforcement authority; intra- and inter-agency collaboration; and commitment to data quality and protection. Interviewees identified three promising areas for future PDMP efforts: data sharing and analysis; integration of PDMP data with electronic medical records; and training for current and potential PDMP users.

CONCLUSIONS

Our findings reveal areas that states may want to prioritize, including improving prescribers' knowledge and use of the PDMP as well as fostering inter-agency collaborations that include PDMP staff. By capitalizing on these opportunities, state governments may improve the effectiveness of their PDMPs, potentially making them more useful tools to curb the morbidity and mortality associated with opioid use disorders.

摘要

背景

与阿片类药物相关的过量用药死亡是一项重大的公共卫生挑战。49个州已实施处方药监测计划(PDMPs),该计划收集有关个人处方药的信息。对于州政府实施PDMPs的情况知之甚少。我们对PDMP工作人员、执法官员和行政机构雇员进行了半结构化访谈,以了解他们对PDMPs的态度和经历。

方法

2015年5月至2016年6月,我们在四个州对州行为者进行了37次半结构化访谈。问题集中在受访者对PDMP目标、主办机构特征以及未来PDMP举措的看法上。各州是有目的地选取的。通过有目的抽样和滚雪球抽样确定受访者。

结果

受访者确定PDMP的关键目标为:改善患者的治疗决策;影响处方行为;协助识别“多科就诊者”;并作为执法工具。受访者认为以下特征是PDMP主办机构的关键特征:监管和执法权;机构内部和机构间合作;以及对数据质量和保护的承诺。受访者确定了未来PDMP工作的三个有前景的领域:数据共享与分析;将PDMP数据与电子病历整合;以及对当前和潜在的PDMP用户进行培训。

结论

我们的研究结果揭示了各州可能希望优先考虑的领域,包括提高开处方者对PDMP的了解和使用,以及促进包括PDMP工作人员在内的机构间合作。通过利用这些机会,州政府可能会提高其PDMP的有效性,有可能使其成为更有效的工具,以控制与阿片类药物使用障碍相关的发病率和死亡率。

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