Pharmacists' experiences with a statewide naloxone standing order program in Massachusetts: a mixed methods study.
Pharmacists' experiences with a statewide naloxone standing order program in Massachusetts: a mixed methods study.
复制标题
DOI：
10.1016/j.japh.2021.08.020
复制
发表时间：
2022-01
期刊：
影响因子：
--
通讯作者：
Walley AY
中科院分区：
文献类型：
--
作者：
Pollini RA;Slocum S;Ozga J;Joyce R;Xuan Z;Green TC;Walley AY
在之前在马萨诸塞州进行的全州范围内的纳洛酮购买试验中，我们记录了在该州的长期订单计划下纳洛酮的高分配率。这项研究的目的是了解在马萨诸塞州纳洛酮常规计划(NSO)下促进纳洛酮获得的因素，并确定任何可干预的剩余障碍。混合方法设计包括一项药剂师调查和三个药剂师焦点小组。焦点小组在三个不同的药剂师专业会议上进行(N=27)。这项调查是在马萨诸塞州各地分层随机抽样连锁店和独立零售药店工作的马萨诸塞州药剂师(N=339)中进行的。所有数据均在2018年9月至2019年11月期间收集。NSO实施的促进者和障碍以及纳洛酮配药和药剂师对纳洛酮和阿片类药物使用的态度和信念。大多数药剂师描述NSO的实施是直截了当的，尽管在调查和焦点小组中都报告了不同的药房类型。促进者包括在连锁药店集中实施，获取网上资源，定期储存纳洛酮，以及使用特定于纳洛酮的服药形式。障碍包括患者保密问题和支付/成本问题。只有31%的受访药剂师报告总是提供纳洛酮咨询；最常被提及的障碍是感觉到患者不适(21%)和时间限制(14%)。保密空间也是独立(与连锁)药剂师更关心的问题(18%对6%，p=0.008)。大多数药剂师对纳洛酮持支持态度，尽管一些人报告对纳洛酮的供应有道德/伦理上的担忧。我们记录了NSO实施和纳洛酮分配的几个促进者。需要改进的领域包括解决围绕阿片类药物和纳洛酮使用的耻辱和误解。这些仍然是改善基于药房的纳洛酮分配的重要目标，尽管我们的总体积极结果表明，马萨诸塞州实施NSO的经验可以为其他州扩大基于药房的纳洛酮获取途径提供参考。
In a prior statewide naloxone purchase trial conducted in Massachusetts, we documented a high rate of naloxone dispensing under the state’s standing order program. The purpose of this study was to understand the factors that facilitate naloxone access under the Massachusetts naloxone standing order (NSO) program and identify any remaining barriers amenable to intervention. Mixed methods design involving a pharmacist survey and three pharmacist focus groups. Focus groups were conducted at three separate professional conferences for pharmacists (N=27). The survey was conducted among Massachusetts pharmacists (N=339) working at a stratified random sample chain and independent retail pharmacies across Massachusetts. All data were collected between September 2018 and November 2019. Facilitators and barriers to NSO implementation and naloxone dispensing and pharmacists’ attitudes and beliefs regarding naloxone and opioid use. Most pharmacists described NSO implementation as being straightforward, although differences were reported by pharmacy type in both the survey and focus groups. Facilitators included centralized implementation at chain pharmacies, access to web-based resources, regularly stocking naloxone, and use of naloxone-specific intake forms. Barriers included patient confidentiality concerns and payment/cost issues. Only 31% of surveyed pharmacists reported always providing naloxone counseling; the most commonly cited barriers were perceived patient discomfort (21%) and time limitations (14%). Confidential space was also more of a concern for independent (vs chain) pharmacists (18% vs 6%, p=0.008). A majority of pharmacists held supportive attitudes toward naloxone, though some reported having moral/ethical concerns about naloxone provision. We documented several facilitators to NSO implementation and naloxone dispensing. Areas for improvement include addressing stigma and misconceptions around opioids and naloxone use. These remain important targets for improving pharmacy-based naloxone dispensing, though our overall positive results suggest Massachusetts’ experience with NSO implementation can inform other states’ efforts to expand pharmacy-based naloxone access.
登录
查看更多内容
DOI：
10.1016/j.japh.2017.01.013
发表时间：
2017-03-01
影响因子：
2.1
作者：
Green, Traci C.;Case, Patricia;Bratberg, Jeffrey
通讯作者：
Bratberg, Jeffrey
DOI：
10.3390/pharmacy8040205
发表时间：
2020-11-03
期刊：
Pharmacy (Basel, Switzerland)
影响因子：
--
作者：
Cernasev A;Veve MP;Talbott T;Hall EA;Hohmeier KC
通讯作者：
Hohmeier KC
影响因子：
5.5
作者：
Egan, Kathleen L.;Foster, Samantha E.;Lee, Joseph G. L.
通讯作者：
Lee, Joseph G. L.
影响因子：
4.2
作者：
Gertner, Alex K.;Domino, Marisa Elena;Davis, Corey S.
通讯作者：
Davis, Corey S.
影响因子：
4.4
作者：
Antoniou, Tony;Pritlove, Cheryl;Gomes, Tara
通讯作者：
Gomes, Tara