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医疗补助计划参与社区零售药房分发布普伦诺芬的障碍
Patricia R Freeman1, Lindsey R Hammerslag2, Katherine A Ahrens3
1Department of Pharmacy Practice and Science, University of Kentucky, Lexington.
JAMA health forum
|May 17, 2024
概括
高达20%的药房没有分发布普伦诺芬,为患有阿片类药物使用障碍的患者创造了障碍. 除了监管合规之外,其他因素也会影响药店对这种必需药物的发行决定.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
背景情况:
- 像布普伦诺芬这样的受管制物质面临着影响药房库存和分发的监管障碍.
- 新出现的证据表明,药房层面的障碍阻碍了对阿片类药物使用障碍 (OUD) 治疗的布普伦诺芬获取,即使是在分发其他阿片类药物的药房中.
研究的目的:
- 确定参与医疗补助计划的零售药房中,分发布普伦诺芬的比例.
- 评估这些药房之间的布普伦诺芬分发是否因医疗补助患者数量或农村-城市位置而有所不同.
主要方法:
- 一项连续的横截面研究分析了美国六个州的2016-2019年的医疗补助药房索赔情况.
- 包括社区零售药店服务于医疗补助患者;不包括邮购药店.
- 药房根据中位数的医疗补助患者数量和农村 (城市/农村) 分类.
主要成果:
- 药房向医疗补助计划注册者分发布普伦诺芬的百分比从2016年的72.0%增加到2019年的80.4%.
- 布普伦诺芬发行情况在州一级存在显著差异.
- 2019年,医疗补助计划患者数量较少的药房与数量较高的药房 (91.7%) 相比,发放布普伦诺芬的频率较低 (69.1%).
结论:
- 高达20%的社区零售药房没有分发布普伦诺芬,这表明医疗补助计划患者寻求OUD治疗的药房层面障碍.
- 除了遵守"管制物质法案"之外的因素也可能影响了分发布普伦诺芬的决定,因为一些药房分发其他阿片类药物,但不分发布普伦诺芬.
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