Evaluation of nurses' attitudes and behaviors regarding narcotic drug safety and addiction: a descriptive cross-sectional study.

BACKGROUND: By evaluating nurses' attitudes and behaviors regarding narcotic drug safety and addiction, effective strategies need to be developed for combating addiction in healthcare institutions. This study, aimed at providing an insight into patient and staff safety issues through the formulation of health policies, aimed to evaluate nurses' attitudes and behaviors regarding narcotic drug safety and addiction. METHODS: The study was conducted in a descriptive cross-sectional design. It was carried out with 191 nurses in a public hospital between March 2023 and August 2023. Data were collected through face-to-face interviews, gathering socio-demographic information and utilizing the Addictive Substance Attitude Scale. The data were analyzed using independent sample t-tests, one-way ANOVA tests, and regression analysis (P < .001 and p < .05). RESULTS: The average age of the participants was determined to be 36.58 ± 8.40. It was reported by 85.3% of nurses that narcotic drug follow-ups in their units were conducted according to procedures. In the study, it was found that 63.9% of nurses did not know the procedure to be followed towards a healthcare professional identified as a narcotic substance addict. The total mean score of the Addictive Substance Attitude Scale of nurses participating in the study was 74.27 ± 14.70. A significant difference was found between the total scores of the scale and the level of education of nurses, the follow-up status of the drugs in the unit where they work, their status of receiving narcotic drug addiction training, and their routine use of the half-dose drug disposal form (p < .05). CONCLUSIONS: The findings of this study underscore the importance of evaluating nurses' attitudes and behaviors regarding narcotic drug safety and addiction. These results indicate the need for nursing administrators, particularly in terms of patient and staff safety, to adopt more effective policies and strategies.

Analysis of Barriers to Medical Opioid Pain Medication Using the Japanese Version of the Barriers Questionnaire II (JBQ-II): Pharmacists and Nurses Perspective in Japan.

BACKGROUND: Some Japanese patients with cancer pain have negative beliefs regarding opioid therapy. The Japanese version of the Barriers Questionnaire II (JBQ-II) determines barriers to cancer pain management. Few studies reported JBQ-II scores in Japan, and none focused on pharmacists. Accordingly, we aimed to explore the relationship between health care professionals' knowledge of and willingness to use opioids, and their JBQ-II scores. Additionally, the variances in JBQ-II scores among nurses, hospital pharmacists, and pharmacy pharmacists were assessed. METHODS: This cross-sectional survey employed the JBQ-II for nurses and pharmacists in hospitals and pharmacies across Japan. Participants were requested to respond to the JBQ-II concerning their affiliation, knowledge of opioid analgesics, and willingness to utilize these drugs for medical practice. RESULTS: A total of 55 hospital pharmacists, 25 pharmacy pharmacists, and 24 nurses responded to the survey. The group-knowledgeable about medical use of narcotics had significantly lower total JBQ-II scores (25.43, standard deviation [SD]: 15.11) than those had by the group with insufficient knowledge (34.50, SD: 18.41). There was no statistically significant difference in total JBQ-II scores among those willing to use opioids medically. The total JBQ-II scores of hospital pharmacists, pharmacy pharmacists, and nurses were 31.00 (SD: 15.11), 33.96 (SD: 19.25), and 27.21 (SD: 15.56), respectively. However, the differences were not statistically significant. CONCLUSIONS: Health care professionals in Japan with knowledge about opioids for medical purposes had a significantly lower total JBQ-II score than those with insufficient knowledge. Thus, health care professionals' knowledge plays a crucial role in reducing barriers to using narcotic drugs.

Narcotics information management system in South Korea: system development and innovation.

BACKGROUND: As the misuse and abuse of medical narcotics are increasing in South Korea, an information system for the integrated information management of medical narcotic drugs across the nation is needed. This paper presents the development process of the Narcotics Information Management System (NIMS) for the monitoring of medical narcotics usage and the results of its implementation. METHODS: As the NIMS enforces that all narcotics handlers digitally report all information on handling medical narcotic drugs, the functional requirements of the NIMS have been identified in accordance with the Narcotics Control Act. In addition to the functional requirements, the non-functional requirements of the NIMS have been elicited by major narcotics handlers and their associations. The non-functional requirements include privacy, availability, connectivity, interoperability, and data integrity. The system design with entity-relationship diagrams and its implementation processes have been presented. RESULTS: The NIMS encompasses all narcotic handlers, which comprise exporting, importing, and pharmaceutical companies; wholesalers; hospitals and clinics; and pharmacies, collecting over 120 million cases annually. It enables transparent monitoring throughout the life cycle, from manufacturing, sales, purchase, and disposal of narcotics. As a result, the number of prescriptions for medical narcotics has been reduced by 9.2%. CONCLUSIONS: To the best of our knowledge, the NIMS is the world's first system to manage all information on the total life cycle of medical narcotics, including imports, production, distribution, use, and disposal of drugs. This system has enabled the safety management and monitoring of medical narcotic drugs. Additionally, it provides consistent and transparent information to physicians and patients, leading to the autonomous safety management of narcotics. The successful development of the NIMS can provide guidelines for implementing a narcotics management system in other countries.

Compliance of Private Pharmacy Retail Outlets to Narcotic Drug Regulations in Ethiopia: A Cross-Sectional and Simulated Client Study Method.

BACKGROUND: Inappropriate use of narcotic drugs is a growing worldwide health challenge. The problem is even worse in Sub-Saharan Africa where organized supply chain regulations on dispensing and stock management are poor for controlling these global challenges. METHODS: A mixed method, descriptive cross-sectional and simulated client study design was used from September 10, 2020 to November 26, 2020 to assess the extent of utilization and compliance of narcotic drug dispensing in private pharmacy retail outlets of Gondar and Bahir Dar town of Amhara region, Ethiopia. A total of 107 private pharmacy outlets were on duty. But in simulated study, purposive sampling is a method that prioritizes study units having the data of interest. RESULTS: A total of 107 private pharmacy retails outlets were included in the survey. The average compliance to the controlled prescription regulation of Ethiopia in all pharmacy outlets (107) of the five drugs were calculated and found to be poor, 23.9% (SD = 18.3%). Compliance to strong narcotics is extremely low, 3.3 % for pethidine and 8% for morphine. Religion of the professionals has significant association with compliance to the prescription of narcotic drugs (p < .001). DISCUSSION: In the era of narcotic epidemics, as a result of growing global inappropriate use of controlled drugs, the finding of this study gives an insight for a serious and strict regulation in managing and controlling the overall distribution of the narcotic drugs. CONCLUSIONS: The compliance of the private retail pharmacies of Ethiopia to the regulation of controlled drugs is low.

Managing Acute Dental Pain: Principles for Rational Prescribing and Alternatives to Opioid Therapy.

Pharmacotherapy forms an integral part of acute dental pain management. In a majority of cases, safe and effective management of acute dental pain can be accomplished with a non-opioid medication regimen. Nonetheless, in certain circumstances use of opioid medications may be needed. Furthermore, there are various pain management regimens, such as pre-emptive analgesia, post-procedural cold compression, use of long acting anesthetic, and compound drug therapy that can improve the efficacy of analgesics to achieve a desired therapeutic response without compromising patient safety.

Discrimination of narcotic drugs in human urine based on nanoplasmonics combined with chemometric method.

The detection of psychoactive substances is an important branch of modern analytical chemistry and has many legally and socially relevant implications. The use of a surface plasmon resonance (SPR)-based gene-nanoparticle system has emerged as a promising technique for the rapid and ultrasensitive detection of molecular species such as drugs of abuse in biofluids. However, the development of a viable screening tool for the detection of multiple classes of drugs in complex media is a considerable challenge because the existing techniques lack affinity toward certain species due to matrix interference. Our aim was to develop a simple optical sensor array for the classification of nine narcotic drugs in aqueous solution and human urine. The UV-vis spectra of DNA-gold nanoparticles in the presence of nine narcotic drugs (pentobarbital sodium, caffeine, morphine, remifentanil, fentanyl, ketamine, etomidate, carfentanil, and sulfentanyl) were distinctly different. Furthermore, the narcotic drugs present in aqueous solution and in human urine were classified correctly through partial least squares discriminant analysis (PLS-DA). Combination with a multi-sensor unit further improved the prediction accuracy of the PLS-DA models. The proposed method has potential for on-site drug detection and drug abuse screening.

Discussion on Using Quality Control Circle to Improve the Qualified Rate of Anesthesia Prescription in Our Hospital / 中国药学杂志

OBJECTIVE: To explore the application effect of quality control circle management in improving the qualified rate of anesthetic drugs prescription in hospital. METHODS: The quality control circle was established to explore the causes of the unqualified anesthetic drugs prescription in our hospital by using the 80/20 rule and fish-bone diagram. The measures to improve the prescription pass rate were determined, and the changes of the prescription pass rate before and after QCC management were compared through the implementation and review of the measures. RESULTS: Using the management of quality control circle, the prescription quality of inpatient anesthetic drugs was significantly improved in our hospital in 2018 and the qualified rate increased from 70.07% in 2017 to 2018 97.78% above target value of 6.69%. After continuous quality control circle management, the qualified rate of prescription increased to 99.33% in the first three quarters of 2019. CONCLUSION: The development of QCC can effectively improve the qualified rate of anesthetic drugs prescription in hospital, not only standardizing the use of anesthetic drugs, promoting drug safety of patients, but also improving the comprehensive quality of pharmacists and the quality of hospital pharmaceutical care.

Informationization Construction and Practice of Outpatient Narcotic Drug Management in Our Hospital / 中国药房

OBJECTIVE:To provide reference for informationized construction of outpatient narcotic drug management in the hospital. METHODS:The narcotic drugs management system,which consisted of the hospital information system and the intelli-gent management machine of narcotic drugs were introduced in working procedure and informationized management,and its effects were evaluated. RESULTS:After informationized construction,the recycling of empty ampoules and used patches was included in compulsory management procedure;informationized management would be achieved completely from safety management,prescrib-ing and dispensing property management,prescription management,batch number management,outcoming and incoming manage-ment,five specialmanagement,etc. Compared with traditional dispensing mode,the dispensing time of each prescription was shortened under informationized dispensing mode,decreasing from(174±32.3)s to(128±30.7)s(P<0.05). Pharmacists could communicate with physicians online by the system;drug application,incoming,use,inventory reconciliation,special book for reg-istration and special book of account were all completed by electronic recording and electronic registering;the system could auto-matically complete the report form of prescription information for evaluation. CONCLUSIONS:It is feasible of the informationized mode of outpatient narcotic drug management in our hospital.

Analysis of the Utilization of Narcotic Drugs and CategoryⅠPsychotropic Drugs in Our Hospital / 中国药房

OBJECTIVE:To provide reference for rational use of narcotic drugs and category Ⅰ psychotropic drugs. METH-ODS:The utilization of narcotic drugs and category Ⅰ psychotropic drugs in clinical wards of Zhengzhou People's Hospital during Jan.-Dec. in 2014 was analyzed statistically in respects of drug types,department distribution medication purpose,DDDs,DDC, DUI,etc. RESULTS:A total of 16 kinds of narcotic drugs and one kind of categoryⅠpsychotropic drugs were used in 28 981 pre-scriptions of narcotic drugs and category Ⅰ psychotropic drugs in our hospital in 2014;A total of 16 kinds of narcotic drugs and one categery Ⅰ psychotropic drugs were used,narcotic drugs mainly included Sufentanil citrate injection(7 816 prescriptions)and Fentanyl citrate injection (5 104 prescriptions),and category Ⅰ psychotropic drugs mainly was Ketamine hydrochloride injection (190 prescriptions). Narcotic drugs and category Ⅰ psychotropic drugs were mainly used in anesthesia department,pain depart-ment and medical oncology department. Main purpose of narcotic drugs and category Ⅰ psychotropic drugs were intraoperative an-esthesia,cancer pain and postoperative analgesia. Top 3 drugs in the list of DDDs were Sufentanil citrate injection,Fentanyl citrate injection(0.1 mg)and Remifentanil for injection. CONCLUSIONS:The utilization of narcotics and category Ⅰ psychotropic drugs are generally rational in the hospital;the doctors can grasp the indication and medication principle,and use drugs rationally accord-ing to disease condition.

Utilization of narcotic drugs in outpatient and emergency pharmacy in a tertiary hospi tal / 药学实践杂志

Objective To review the usage of narcotic drugs at outpatient and emergency pharmacy in order to promote rational narcotic drug use .Methods A total of 2 940 narcotic prescriptions from outpatient and emergency pharmacy in our hospital during January to June ,2014 and 2015 were collected .Three parameters (the prescription department ,DDDs and DUI) were analyzed statistically .Results Six narcotic drugs were involved ,including three injections ,two tablets and one ex-ternal patch .Emergency Department ,Radiotherapy Department and Analgesia Department are the top three high usage depart-ments .Morphine sulfate sustained-release tablet had the highest DDDs .DDDs of pethidine hydrochloride injection during Janu-ary to June ,2015 was significantly reduced compared to the same period in 2014 .DUI of morphine sulfate sustained-release tablet and bucinnazine hydrochloride tablets increased to some extent .Conclusion The usage of narcotic drugs at outpatient and emergency pharmacy in our hospital was basically reasonable .A few physicians still had problems in proper indication and dosage with narcotic drug use .The specific training programs need to be in place for those physicians .

Application of Intelligent Narcotic Drug Management Cabinet in the Narcotic Drug Management in the Outpatient Pharmacy of Our Hospital / 中国药房

OBJECTIVE:To promote the informationization and standardization of narcotic drug management so as to enhance the level of pharmacy management. METHODS:The function of intelligent narcotic drug management cabinet and its application in our hospital were introduced. The application effects were evaluated by comparing the indexes in 1 month(or 1 quarter)before and after the adoption of the cabinet. RESULTS:The intelligent narcotic drug management cabinet used in our hospital had such func-tions as login,getting drugs,adding drugs,expiration date management,inventory query,update,shifting of duty,record and da-ta processing. After the adoption,the inventory decreased by 35.2%,turnover rate increased by 53.4%;the time of applying for and registering narcotic drugs by the keeper of secondary warehouse respectively shortened by 84.1%(13.2 min vs. 2.1 min) and 88.9%(10.8 min vs. 1.2 min);and the incidence of external errors reduced from 3 times to once,an decrease of 66.7%. Mean-while,high integration of space improved the overall image of the pharmacy and the automatic pharmacy was constructed on a cer-tain scale and in a systematic manner. CONCLUSIONS:The application of intelligent narcotic drug management cabinet to the out-patient pharmacy can reduce the inventory cost,increase work efficiency and the safety of drug use,and make the narcotic drug management more standard,scientific and sophisticated.

Analysis of narcotic drug use in China from 2003 to 2013 / 中国药学杂志

OBJECTIVE: To analyze the application of narcotic drugs, and to discuss the trends of drug use and problems. METHODS: Based on the national data of narcotic drug, the total amount of drugs and DDDs were analyzed. RESULTS: In recent years, total amount of narcotic drugs in our country is in a relatively stable state, medication strength have improved. However, a large gap still exists in the level of total amount of medication and per capita drug use compared with global average level and these of developed countries. The amount of morphine and oxycodone increased year by year, the amount of pethidine declined. Fentanyl took the lead in DDDs. CONCLUSION: The rationality of narcotic drugs are increasing, but there are still unreasonable.

Development and Application of Management System of Narcotic Drugs in Outpatient Pharmacy / 中国药房

OBJECTIVE:To develop a management system of narcotic drugs for the management of narcotics in outpatient pharmacy. METHODS: The management system of narcotic drugs in outpatient pharmacy was developed by using Visual Basic programming language and Access database,and the management system was applied for prescription registration of the narcotic drugs and management on the reclaiming of empty ampoules and the remained drugs,etc. By inquiring the management system,the Excel file of the management documents of narcotic drugs was able to be obtained. RESULTS: This system improved each link in the management of narcotic drugs in outpatient pharmacy and simplified the operational steps and improved the management quality and work efficiency,furthermore,the data obtained were accurate and reliable. CONCLUSION: The management system of narcotic drugs in outpatient pharmacy was proved to be a pragmatic management tool of narcotic drugs.

Analysis of 6 894 Prescriptions of Narcotic Drug in Out-patient Department of PLA General Hospital / 药物流行病学杂志

Objective:To investigate the situation of narcotic drug use in the out-patient department of our hospital to provide reference for the rational use of drugs.Method:By collecting all the prescriptions of the out-patient department of our hospital in 2007,the designations,dosages,dosage form,usage,synptoms and section offices of the narcotic drug were statistically analyzed.Result:Top 3 of the prescriptions amounts in the out-patient department were morphine sulfate sustained-Relrase tablets,pethidine hydrochloride injection and oxycodone hydrochloride sustained-release tablets. Top 3 of the prescriptions amounts in DUI were fentanyl citrate injecton,bucinnazine hydrochlooride injection and morphine hydrochloride injection.Conclusion:The narcotic drug used in the out-patient clinic of our hospital is rational on the whole,and the doctors and pharmacists should pay much attention to the use and management of narcotic drug.

Analysis of Narcotic Drug Use from 2002 to 2005 in Our Hospital / 中国药房

OBJECTIVE: To evaluate the current situation and trend of narcotic drug use in our hospital where the authors work in order to provide the reference for scientific management and rational use of these drugs. METHODS: The yearly amount of narcotic drugs administered in the whole hospital, the yearly amount in the separate departments, as well as drug expenditures and ratios between January 2002 and November 2005 were added up and analyzed statistically. RESULTS: The amount of bucinnazine use dominated in the first. The amount of morphine for oral use was increasing year by year. The amount of fentangl transdernal patch use was also bigger and increasing rapidly. However, the amount of pethidine and morphine for injection use was decreasing. CONCLUSION:Analgetics for oral and transdermal use will be the main categories of analgetics in the future.