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首页> 外文期刊>The International journal of drug policy >Impact of training for healthcare professionals on how to manage an opioid overdose with naloxone: effective, but dissemination is challenging.
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Impact of training for healthcare professionals on how to manage an opioid overdose with naloxone: effective, but dissemination is challenging.

机译：培训医疗保健专业人员对如何使用纳洛酮治疗阿片类药物过量的影响：有效，但传播具有挑战性。

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BACKGROUND: Opioid overdose has a high mortality, but is often reversible with appropriate overdose management and naloxone (opioid antagonist). Training in these skills has been successfully trialled internationally with opioid users themselves. Healthcare professionals working in substance misuse are in a prime position to deliver overdose prevention training to drug users and may themselves witness opioid overdoses. The best method of training dissemination has not been identified. The study assessed post-training change in clinician knowledge for managing an opioid overdose and administering naloxone, evaluated the 'cascade method' for disseminating training, and identified barriers to implementation. METHODS: A repeated-measures design evaluated knowledge pre-and-post training. A sub-set of clinicians were interviewed to identify barriers to implementation. Clinicians from addiction services across England received training. Participants self-completed a structured questionnaire recording overdose knowledge, confidence and barriers to implementation. RESULTS: One hundred clinicians were trained initially, who trained a further 119 clinicians (n=219) and thereafter trained 239 drug users. The mean composite score for opioid overdose risk signs and actions to be taken was 18.3/26 (+/-3.8) which increased to 21.2/26 (+/-4.1) after training, demonstrating a significant improvement in knowledge (Z=9.2, p<0.001). The proportion of clinicians willing to use naloxone in an opioid overdose rose from 77% to 99% after training. Barriers to implementing training were clinician time and confidence, service resources, client willingness and naloxone formulation. CONCLUSIONS: Training clinicians how to manage an opioid overdose and administer naloxone was effective. However the 'cascade method' was only modestly successful for disseminating training to a large clinician workforce, with a range of clinician and service perceived obstacles. Drug policy changes and improvements to educational programmes for drug services would be important to ensure successful implementation of overdose training internationally.
机译：背景：阿片类药物过量具有较高的死亡率，但通常可以通过适当的过量管理和纳洛酮（阿片类药物拮抗剂）来逆转。这些技能的培训已在阿片类药物使用者自己的国际范围内成功进行了试用。从事药物滥用工作的医疗保健专业人员处于首要地位，可以为吸毒者提供预防过量药物的培训，他们自己可能会发现阿片类药物过量。尚未确定培训传播的最佳方法。这项研究评估了培训后临床医生在处理阿片类药物过量和纳洛酮方面的知识变化，评估了“级联法”来传播培训，并确定了实施的障碍。方法：重复测量设计评估了知识的培训前后。采访了一组临床医生，以确定实施的障碍。来自英格兰各地成瘾服务机构的临床医生接受了培训。参与者自行完成了一份结构化的问卷，记录了过量的知识，信心和实施障碍。结果：最初培训了一百名临床医生，他们又培训了119名临床医生（n = 219），然后培训了239名吸毒者。阿片类药物过量风险征兆和应采取的行动的平均综合评分为18.3 / 26（+/- 3.8），经训练后增加至21.2 / 26（+/- 4.1），表明知识水平得到了显着提高（Z = 9.2， p ＜0.001）。训练后愿意在纳阿片类药物中使用纳洛酮的临床医生比例从77％上升到99％。实施培训的障碍包括临床医生的时间和信心，服务资源，服务对象的意愿以及纳洛酮的制定。结论：培训临床医生如何处理阿片类药物过量和纳洛酮是有效的。但是，“级联方法”在将培训传播给庞大的临床医生队伍方面仅取得了一定程度的成功，其中存在许多临床医生和服务人员遇到的障碍。毒品政策的变化以及对毒品服务教育计划的改进对于确保在国际上成功实施药物过量培训至关重要。

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