Nonprescription naloxone and syringe sales in the midst of opioid overdose and hepatitis C virus epidemics: Massachusetts, 2015
Nonprescription naloxone and syringe sales in the midst of opioid overdose and hepatitis C virus epidemics: Massachusetts, 2015
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DOI：
10.1016/j.japh.2016.12.077
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发表时间：
2017-03-01
影响因子：
2.1
通讯作者：
Green, Traci C.
中科院分区：
文献类型：
--
作者：
Stopka, Thomas J.;Donahue, Ashley;Green, Traci C.
目的：确定非处方药纳洛酮和无菌注射器销售的流行率，非处方药销售的相关因素，非处方药纳洛酮和注射器销售药店的地理空间准入，以及潜在干预的目标。设计：横断面研究。背景和参与者：在过去的十年中，马萨诸塞州报告的阿片类药物过量和丙型肝炎病毒病例急剧增加。药剂师有潜力在增加非处方药纳洛酮和无菌注射器的获得方面发挥重要作用，这两种注射器分别可以逆转阿片类药物过量和减少丙型肝炎病毒的传播。2015年，我们完成了对马萨诸塞州1042家零售药店中的809家的简短电话调查(回应率=77.6%)，以评估非处方药销售纳洛酮和无菌注射器的经验。结果：我们的主要结果是药房储存和销售纳洛酮(是或否)，用于非处方药销售和非处方药注射器销售(是或否)。我们利用地理信息系统进行了多变量回归分析并创建了地图，以确定与纳洛酮和无菌注射器非处方药销售相关的因素，并提高我们对以药房为基础的纳洛酮和注射器销售的地理空间的了解。结果：超过97%的药店报告在不需要处方的情况下销售无菌注射器，45%的药店报告储存和销售纳洛酮。与非处方药销售相关的因素包括手术时间、对减少伤害活动的经验和兴趣，以及存在阿片类药物过量热点。无菌注射器的非处方药销售在地理上很普遍，而纳洛酮在地理上的销售有限。接受调查的药剂师对了解纳洛酮的益处、应用和分配需求的培训很感兴趣。结论：在马萨诸塞州，通过非处方药销售获得无菌注射器的情况很多，尽管有超过350家药店(45%)报告储存和销售纳洛酮以防止阿片类药物过量死亡，但药房工作人员在获得和培训方面仍有很大的改进空间。(C)2017年美国药剂师协会(R)。爱思唯尔公司出版，版权所有。
Objectives: To determine the prevalence of nonprescription naloxone and sterile syringe sales, factors associated with nonprescription sales, geospatial access to nonprescription naloxone and syringe-selling pharmacies, and targets for potential interventions.Design: Cross-sectional study.Setting and participants: Massachusetts has experienced steep increases in reported opioid overdoses and hepatitis C virus cases in the past decade. Pharmacists have the potential to play a substantial role in increasing access to nonprescription naloxone and sterile syringes, which can reverse opioid overdoses and decrease hepatitis C virus transmission, respectively. We completed brief telephone surveys with 809 of 1042 retail pharmacies across Massachusetts (response rate = 77.6%) during 2015 to assess experience with nonprescription sales of naloxone and sterile syringes.Outcome measures: Our primary outcomes were the stocking and selling of naloxone in the pharmacy (yes or no) for nonprescription sales and nonprescription syringe sales (yes or no). We conducted multivariable regression analyses and created maps using a geographic information system to identify factors associated with nonprescription sales of naloxone and sterile syringes, and to improve our understanding of geospatial access to pharmacy-based naloxone and syringe sales.Results: More than 97% of pharmacies reported selling sterile syringes without requiring a prescription, and 45% of pharmacies reported stocking and selling naloxone. Factors associated with nonprescription sales included hours of operation, experience with and interest in harm reduction activities, and presence in an opioid overdose hotspot. Geographic access to nonprescription sale of sterile syringes is widespread, whereas geospatial access to naloxone is limited. Training to understand the benefits, applications, and distribution needs of naloxone is of interest to surveyed pharmacists.Conclusion: Access to sterile syringes through nonprescription sales is strong across Massachusetts, and although more than 350 pharmacies (45%) reported stocking and selling naloxone to prevent opioid overdose deaths, there is much room for improvement in access and training among pharmacy staff members. (C) 2017 American Pharmacists Association (R). Published by Elsevier Inc. All rights reserved.