丁丙诺啡
医学
阿片类药物使用障碍
药方
缓和医疗
美沙酮
重症监护医学
受控物质
风险评估
梅德林
药物滥用
精神科
类阿片
护理部
受体
计算机安全
计算机科学
政治学
内科学
法学
作者
Jennifer Huggins,Jennifer Ashley,Tracy Fasolino
出处
期刊:Journal of Hospice & Palliative Nursing
[Ovid Technologies (Wolters Kluwer)]
日期:2024-08-15
卷期号:26 (5): 249-256
标识
DOI:10.1097/njh.0000000000001058
摘要
Substance use disorder (SUD) affects more than 1 in 6 Americans older than 12 years and has become an increasingly relevant topic in palliative care. Lack of clear guidelines and fragmented care results in patient safety concerns and poor outcomes. This rapid review aims to present the current literature on opioid contracts/agreements, prescription drug monitoring database access, opioid risk assessment tools, and urine drug screening in the palliative care setting. Through a systematic process, we identified 19 articles published between 2018 and 2023 that pertained to substance use disorder and palliative care. Current risk mitigation strategies include prescription drug monitoring, opioid use agreements, risk assessment tools, urine drug screening, and the use of buprenorphine to manage pain. Prescription drug monitoring programs are state-based electronic databases that track controlled substances, and there are numerous risk assessment tools. Urine drug screening involves the use of both immunoassay and confirmatory chromatography to determine the presence or absence of either the prescribed controlled substance or unexpected findings including illicit drugs or prescription-controlled substances that are not prescribed to the patient. The goal of mitigating risk and reducing harm while providing expert symptom management is the challenge that palliative care transdisciplinary teams face as they continue to care for patients with substance use disorder. This review points to the need for further research on how to incorporate these harm-reducing strategies into clinical practice.
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