Pharmacists' role in opioid overdose: Kentucky pharmacists' willingness to participate in naloxone dispensing
Pharmacists' role in opioid overdose: Kentucky pharmacists' willingness to participate in naloxone dispensing
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DOI：
10.1016/j.japh.2016.12.064
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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：
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作者：
Freeman, Patricia R.;Goodin, Amie;Green, Traci C.
目的：评估药师对启动纳洛酮处方的意愿。从2015年起，肯塔基州法律允许注册药剂师根据医生批准的协议分配纳洛酮。设计：电子调查(电子邮件)评估药剂师在阿片类药物过量中所扮演的角色以及对纳洛酮分配的态度和障碍。背景和参与者：2015年所有拥有有效执照的肯塔基州药剂师。主要观察指标：使用有序Logistic回归估计药剂师的特征和态度对启动纳洛酮分配意愿的影响，其中因变量被操作为一个Likert型问题，从1(完全不愿意)到6(非常愿意)。结果：在4699名肯塔基州执业药剂师中，1282人回答其中社区从业人员834人(应答率27.3%)。药剂师报告了不同的意愿，37.3%的人非常愿意(得分5或6)，27.9%的人不愿意(得分1或2)。然而，大多数药剂师报告愿意开出有效处方的纳洛酮(54.0%，得分5或6)。女性药剂师愿意开始纳洛酮配药的可能性是男性的1.3倍(95%可信区间[CI]1.0-1.6)。那些报告对确定有过量用药风险的人有信心的人启动配药的可能性是1.2倍，那些报告有信心有能力教育患者有关过量用药的人表示愿意启动纳洛酮配药的可能性是1.6倍(95%的CI分别为1.0-1.3和1.4-1.8)。社区药剂师报告说，与其他执业环境的药剂师相比，他们获得纳洛酮的障碍更高。结论：肯塔基州的药剂师在启动纳洛酮处方的意愿方面存在分歧；然而，那些对自己识别过量用药风险的能力有信心的人更愿意。通过适当设计的教育计划增加药剂师的信心，可以促进药剂师参与纳洛酮处方。(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 assess pharmacists' willingness to initiate the dispensing of naloxone. As of 2015, Kentucky law permits certified pharmacists to dispense naloxone under a physician-approved protocol.Design: Electronic survey (e-mail) gauging perception of pharmacists' role in opioid overdose and attitudes toward, and barriers to, naloxone dispensing.Setting and participants: All Kentucky pharmacists with active licenses in 2015.Main outcome measures: Ordinal logistic regression was used to estimate the impact of pharmacist characteristics and attitudes on willingness to initiate naloxone dispensing, where the dependent variable was operationalized as a Likert-type question on a scale of 1 (not at all willing) to 6 (very willing).Results: Of 4699 practicing Kentucky pharmacists, 1282 responded, of which 834 were community practitioners (response rate 27.3%). Pharmacists reported varying willingness to initiate naloxone dispensing, with 37.3% very willing (score 5 or 6) and 27.9% not willing (score 1 or 2). However, a majority of pharmacists reported willingness to dispense naloxone with a valid prescription (54.0%, score 5 or 6). Women pharmacists were 1.3 times more likely than men to be willing to initiate naloxone dispensing (95% confidence interval [CI] 1.0-1.6). Those who reported confidence in identifying individuals at risk for overdose were 1.2 times more likely to initiate dispensing, and those who reported confidence in ability to educate patients about overdose were 1.6 times more likely to express willingness to initiate naloxone dispensing (95% CIs, respectively, 1.0-1.3 and 1.4-1.8). Community pharmacists reported barriers to naloxone access at higher rates than pharmacists from other practice settings.Conclusion: Kentucky pharmacists are divided in their willingness to initiate naloxone dispensing; however, those who are confident in their ability to identify overdose risks are more willing. Increasing pharmacist confidence through appropriately designed education programs could facilitate pharmacist participation in naloxone dispensing. (C) 2017 American Pharmacists Association (R) . Published by Elsevier Inc. All rights reserved.