TY - JOUR
KW - Ambulatory Care Facilities
KW - Analgesics, Opioid/toxicity
KW - Drug Overdose/prevention & control
KW - Education, Medical, Continuing
KW - Health Knowledge, Attitudes, Practice
KW - Humans
KW - Naloxone/therapeutic use
KW - Narcotic Antagonists/therapeutic use
KW - Physicians/psychology
KW - United States
KW - United States Department of Veterans Affairs
KW - naloxone
KW - OEND
KW - Opioid
KW - Overdose education
KW - primary care
KW - risk compensation
AU - Rachel P. Winograd
AU - Corey S. Davis
AU - Maria Niculete
AU - Elizabeth Oliva
AU - Richard P. Martielli
A1 - 
AB - BACKGROUND: Overdose from opioids is a serious public health and clinical concern. Veterans are at increased risk for opioid overdose compared with the civilian population, suggesting the need for enhanced efforts to address overdose prevention in Department of Veterans Affairs (VA) health care settings, such as primary care clinics. METHODS: Prescribing providers (N = 45) completed surveys on baseline knowledge and concerns about the VA Overdose Education and Naloxone Distribution (OEND) initiative prior to attending an OEND educational training. RESULTS: Survey items were grouped into 4 OEND-related categories, reflecting (1) lack of knowledge/familiarity/comfort; (2) concerns about iatrogenic effects; (3) concerns about impressions of unsafe opioid prescribing; and (4) concerns about risks of naloxone prescribing. Although certain OEND-related categories were associated with each other, concerns related to iatrogenic effects of OEND (e.g., patients will use more opioids and/or be less likely to see treatment) and lack of knowledge/familiarity/comfort with OEND were endorsed more than concerns related to giving impressions of unsafe opioid prescribing. The majority of providers endorsed the belief that those prescribing opioids to patients should be responsible for providing overdose education to those patients. System-wide naloxone prescription rates and sources increased over 320% following initiation of OEND expansion efforts, although these increases cannot be viewed as a direct result of the in-service trainings. CONCLUSIONS: Findings demonstrate that some providers believe they lack knowledge of opioid overdose prevention techniques and hold concerns about OEND implementation. More training of medical providers outside substance use treatment settings is needed, with particular attention to concerns about harmful consequences resulting from the receipt of naloxone.
AD - a VA St. Louis Health Care System , St. Louis , Missouri , USA.; b Missouri Institute of Mental Health, University of Missouri , St. Louis , Missouri , USA.; c Network for Public Health Law , Los Angeles , California , USA.; e VA Connecticut Healthcare System , West Haven , Connecticut , USA.; f Department of Psychiatry , Yale School of Medicine , New Haven , Connecticut , USA.; d VA Palo Alto Health Care System , Menlo Park , California , USA.; a VA St. Louis Health Care System , St. Louis , Missouri , USA.
BT - Substance abuse
C5 - Education & Workforce; Opioids & Substance Use
CP - 2
CY - United States
DO - 10.1080/08897077.2017.1303424
IS - 2
JF - Substance abuse
LA - eng
M1 - Journal Article
N2 - BACKGROUND: Overdose from opioids is a serious public health and clinical concern. Veterans are at increased risk for opioid overdose compared with the civilian population, suggesting the need for enhanced efforts to address overdose prevention in Department of Veterans Affairs (VA) health care settings, such as primary care clinics. METHODS: Prescribing providers (N = 45) completed surveys on baseline knowledge and concerns about the VA Overdose Education and Naloxone Distribution (OEND) initiative prior to attending an OEND educational training. RESULTS: Survey items were grouped into 4 OEND-related categories, reflecting (1) lack of knowledge/familiarity/comfort; (2) concerns about iatrogenic effects; (3) concerns about impressions of unsafe opioid prescribing; and (4) concerns about risks of naloxone prescribing. Although certain OEND-related categories were associated with each other, concerns related to iatrogenic effects of OEND (e.g., patients will use more opioids and/or be less likely to see treatment) and lack of knowledge/familiarity/comfort with OEND were endorsed more than concerns related to giving impressions of unsafe opioid prescribing. The majority of providers endorsed the belief that those prescribing opioids to patients should be responsible for providing overdose education to those patients. System-wide naloxone prescription rates and sources increased over 320% following initiation of OEND expansion efforts, although these increases cannot be viewed as a direct result of the in-service trainings. CONCLUSIONS: Findings demonstrate that some providers believe they lack knowledge of opioid overdose prevention techniques and hold concerns about OEND implementation. More training of medical providers outside substance use treatment settings is needed, with particular attention to concerns about harmful consequences resulting from the receipt of naloxone.
PP - United States
PY - 2017
SN - 1547-0164; 0889-7077
SP - 135
EP - 140
EP - 
T1 - Medical providers' knowledge and concerns about opioid overdose education and take-home naloxone rescue kits within Veterans Affairs health care medical treatment settings
T2 - Substance abuse
TI - Medical providers' knowledge and concerns about opioid overdose education and take-home naloxone rescue kits within Veterans Affairs health care medical treatment settings
U1 - Education & Workforce; Opioids & Substance Use
U2 - 28486076
U3 - 10.1080/08897077.2017.1303424
VL - 38
VO - 1547-0164; 0889-7077
Y1 - 2017
Y2 - Apr-Jun
ER -