Study protocol for the Respond to Prevent Study: a multi-state randomized controlled trial to improve provision of naloxone, buprenorphine and nonprescription syringes in community pharmacies.
Study protocol for the Respond to Prevent Study: a multi-state randomized controlled trial to improve provision of naloxone, buprenorphine and nonprescription syringes in community pharmacies.
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DOI：
10.1080/08897077.2021.2010162
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发表时间：
2022
期刊：
影响因子：
3.5
通讯作者：
Hartung, Daniel
中科院分区：
文献类型：
--
作者：
Green, Traci C.;Bratberg, Jeffrey;Irwin, Adriane N.;Boggis, Jesse;Gray, Mary;Leichtling, Gillian;Bolivar, Derek;Floyd, Anthony;Al-Jammali, Zain;Arnold, Jenny;Hansen, Ryan;Hartung, Daniel
获得阿片类解毒剂纳洛酮是解决阿片类药物危机的关键组成部分。纳洛酮是一种人群水平的预防干预措施，与大幅降低过量用药死亡率和减少非致命性过量用药有关。药房在分发治疗阿片使用障碍的丁丙诺啡等药物和销售非处方药注射器方面发挥着关键作用，这使它们处于阿片类药物获取和纳洛酮提供等风险缓解方法的十字路口。随着中国通过医疗系统扩大纳洛酮的实施，优化基于药房的纳洛酮供应的测试方法将是关键。在预防反应研究中，我们对华盛顿州、俄勒冈州、马萨诸塞州和新罕布夏州的社区连锁药店进行了一项以药房为重点的大规模干预研究，以增加纳洛酮的分配并提高阿片类药物的安全性。干预措施整合了两个循证教育工具包和简化的材料，以加强对纳洛酮政策、减少耻辱以及围绕纳洛酮、非处方药注射器和丁丙诺啡获取的患者沟通的关注。这项真实世界的研究对175家社区连锁药店实施了阶梯式楔形随机试验设计，以评估应对措施在增加以下预防干预方面的有效性：a)基于药房的纳洛酮分发率、与纳洛酮相关的患者参与度、药剂师和技术人员对纳洛酮的态度、知识、感知的行为控制和自我效能；以及b)药房的非处方药注射器销售，以及药剂师和技术人员对分配丁丙诺啡治疗阿片类药物使用障碍的态度、知识、感知的行为控制和自我效能(二次结果)。这篇评论简要介绍了这项研究，并就我们研究方案的设计和调整提出了见解，包括在史无前例的新冠肺炎大流行期间通过的方案，以及2020年西方野火进一步加剧的方案。
Access to the opioid antidote naloxone is a critical component of addressing the opioid crisis. Naloxone is a population-level prevention intervention associated with substantial reductions in overdose mortality and reduction of nonfatal overdose. Pharmacies’ pivotal role in dispensing medications like buprenorphine for the treatment of opioid use disorder and selling nonprescription syringes places them at the crossroads of opioid access and risk mitigation methods like naloxone provision. Testing ways to optimize pharmacy-based naloxone provision will be key as the country expands the implementation of naloxone through the medical system. In the Respond to Prevent Study, we conducted a large, practical study of a pharmacy-focused intervention in a sample of Washington, Oregon, Massachusetts and New Hampshire community chain pharmacies to increase naloxone dispensing and improve opioid safety. The intervention integrated two evidence-based educational toolkits and streamlined materials to enhance the focus on naloxone policy, stigma reduction, and patient communications around naloxone, nonprescription syringes and buprenorphine access. The real-world study implemented a stepped wedge, clustered randomized trial design across 175 community chain pharmacies to evaluate the effectiveness of the Respond to Prevent intervention in increasing: a) pharmacy based naloxone distribution rates, naloxone-related patient engagement, and pharmacist and technicians’ attitudes, knowledge, perceived behavioral control and self-efficacy toward naloxone; and b) pharmacy nonprescription syringe sales, and pharmacist and technicians’ attitudes, knowledge, perceived behavioral control and self-efficacy toward dispensing buprenorphine for opioid use disorder (secondary outcomes). This commentary provides a brief narrative about the study and presents insights on the design and adaptations to our study protocol, including those adopted during the unprecedented COVID-19 pandemic further compounded by Western wildfires in 2020.
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DOI：
10.1016/j.japh.2020.03.005
发表时间：
2020-09-01
影响因子：
2.1
作者：
Green, Traci C.;Donovan, Elizabeth;Bratberg, Jeffrey
通讯作者：
Bratberg, Jeffrey
影响因子：
4.4
作者：
Darracq, Michael A.;Lee, Janelle;Armenian, Patil
通讯作者：
Armenian, Patil
DOI：
10.1016/j.japh.2016.12.077
发表时间：
2017-03-01
影响因子：
2.1
作者：
Stopka, Thomas J.;Donahue, Ashley;Green, Traci C.
通讯作者：
Green, Traci C.
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
影响因子：
4.4
作者：
Green, Traci C.;Dauria, Emily F.;Walley, Alexander Y.
通讯作者：
Walley, Alexander Y.