General practitioner engagement with the Scottish National Naloxone Programme: A needs assessment project.

摘要

The Scottish National Naloxone Programme was launched in November 2010 following successful pilots in Scottish sites. The aim of the programme is to reduce Scotland’s high number of drug-related deaths (DRDs) caused by opiate overdose. The national programme is currently being implemented through specialist drug services. However, there may be drug users who are not using such services or have limited access to such services. General Practitioners (GPs) are likely to have direct contact with drug using patients who are on opiate replacement treatment or receiving general medical care. Thus, GPs are in an ideal position to either, direct these patients to Naloxone training and supply schemes, or to provide this service themselves. Additionally, they will often be in contact with friends and family of drug users who may be registered at the same practice; this group is a vital part of the national programme as they potentially would be the ones to administer Naloxone, thus ‘buying’ time for an ambulance to arrive.ududThis needs assessment was commissioned to ensure GPs’ views and knowledge are considered to maximise engagement of GPs in the Scottish National Naloxone Programme.ududDiscussion and conclusionudBoth interviews and the survey indicated that GPs did not currently feel sufficiently skilled or knowledgeable to be involved in Naloxone training and provision. There was a strong need evident for information on DRDs and associated risk factors, and on the prescribing and use of Naloxone, which should be evidence based. A key barrier identified was the typecasting of Naloxone prescribing as a specialist service that only specialists should provide. Negative attitudes to drug users generally were evident and this potential stigmatisation of drug users as a patient group should be reviewed. ududIn conclusion, this research identified minimal awareness among GPs of the national programme. GPs tend to classify Naloxone distribution as a specialist service and therefore assume it is not part of their remit. Even those with higher involvement or specialist training in substance misuse considered this a service that is not necessarily relevant to them. However, there were tentative and encouraging signs that GPs would be willing to be more involved in Naloxone distribution if certain enablers were addressed. Most important of these was training, which should be evidence based, and which was recognised by GP respondents as essential.