Naloxone Availability and Pharmacy Staff Knowledge of Standing Order for Naloxone in Pennsylvania Pharmacies
Naloxone Availability and Pharmacy Staff Knowledge of Standing Order for Naloxone in Pennsylvania Pharmacies
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DOI：
10.1097/adm.0000000000000492
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发表时间：
2019-07-01
影响因子：
5.5
通讯作者：
Meisel, Zachary F.
中科院分区：
文献类型：
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作者：
Graves, Rachel L.;Andreyeva, Elena;Meisel, Zachary F.
目的：为了评估纳洛酮的可用性和价格以及宾夕法尼亚州药房的纳洛酮常备订单的药房工作人员知识。方法：我们从2016年12月至2017年4月进行了一项电话审计研究，对宾夕法尼亚州药房的工作人员进行了调查，以评估纳洛酮的可用性，工作人员对纳洛酮常备订单的理解以及纳洛酮的自付费用。结果：从758家联系药店中的682家获得了答复（90%的答复率）。接受调查的306家（45%）药店有纳洛酮库存（即可供配药）。在376家（55%）没有库存纳洛酮的药店中，118家（31%）表示他们可以在1个工作日内订购纳洛酮。药房工作人员对有关纳洛酮长期订单关键组成部分的问题的回答来自参与调查的682家药房中的581家（85%）。在581名药房工作人员中，有64%的人表示他们要么储存纳洛酮，要么可以订购纳洛酮，64%的人正确回答了与了解纳洛酮长期订单有关的所有问题。审计中所述的自付价格中位数因配方而异，从50美元到4000美元不等。国家药店的工作人员比区域/当地连锁和非连锁药店的工作人员更有可能正确回答不需要处方即可获得纳洛酮（68.5%、57.7%和52.4%，P = 0.0045）。纳洛酮获取的多重障碍存在于一个大的，不同的国家的药店，尽管存在一个长期的秩序，以促进这种访问。纳洛酮在药房的可用性有限，药房工作人员对长期订单缺乏了解或理解，以及该药物自付费用的变化是这些潜在障碍之一。可能需要对药房或药品制造商采取监管或法律的激励措施，对药房工作人员进行教育，或采取其他干预措施，以增加纳洛酮在药房的可用性。
Objective: To assess the availability and price of naloxone as well as pharmacy staff knowledge of the standing order for naloxone in Pennsylvania pharmacies.Methods: We conducted a telephone audit study from December 2016 to April 2017 in which staff from Pennsylvania pharmacies were surveyed to evaluate naloxone availability, staff understanding of the naloxone standing order, and out-of-pocket cost of naloxone.Results: Responses were obtained from 682 of 758 contacted pharmacies (90% response rate). Naloxone was stocked (ie, available for dispensing) in 306 (45%) pharmacies surveyed. Of the 376 (55%) pharmacies that did not stock naloxone, 118 (31%) stated that they could place an order for naloxone for pickup within 1 business day. Responses by pharmacy staff to questions about key components of the standing order for naloxone were collected from 581 of the 682 pharmacies who participated in the survey (85%). Of the 581 pharmacy staff members who stated that they either stocked or could order naloxone, 64% correctly answered all questions pertaining to understanding of the naloxone standing order. The respective median out-of-pocket prices stated in the audit varied by formulation and ranged from $50 to $4000. Staff from national pharmacies were significantly more likely than staff from regional/local chain and non-chain pharmacies to correctly answer that a prescription was not required to obtain naloxone (68.5%, 57.7%, and 52.4% respectively, (P = 0.0045).Conclusions: Multiple barriers to naloxone access exist in pharmacies across a large, diverse state, despite the presence of a standing order to facilitate such access. Limited availability of naloxone in pharmacies, lack of knowledge or understanding by pharmacy staff of the standing order, and variability in out-of-pocket cost for this drug are among these potential barriers. Regulatory or legal incentives for pharmacies or drug manufacturers, education efforts directed toward pharmacy staff members, or other interventions may be needed to increase naloxone availability in pharmacies.