Pharmacy-based statewide naloxone distribution: A novel "top-down, bottom-up" approach
Pharmacy-based statewide naloxone distribution: A novel "top-down, bottom-up" approach
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DOI：
10.1016/j.japh.2017.01.017
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发表时间：
2017-03-01
影响因子：
2.1
通讯作者：
Clark, Karen
中科院分区：
文献类型：
--
作者：
Morton, Kate J.;Harrand, Brianna;Clark, Karen
目的：强调新墨西哥州广泛的药店纳洛酮分布的多方面方法，并分享干预措施作为改善其他州基于药店的纳洛酮实践的工具。背景：2014年，新墨西哥州药物过量死亡率第二高，其中53%与处方阿片类药物有关。阿片类药物过量死亡可以通过使用纳洛酮来预防，纳洛酮是一种安全有效的药物，可逆转处方阿片类药物和海洛因的影响。药剂师可以在向使用处方阿片类药物的个人提供纳洛酮方面发挥重要作用。实践描述：不适用。实践创新：不适用。干预措施：在新墨西哥州采用了从上到下的多方面方法，立法通过了一项全州常设命令的规定，新墨西哥州卫生部支持以药店为基础的纳洛酮交付。还开始了一种自下而上的方法，为药剂师和药学技术人员制定和实施了培训方案。评价：纳洛酮医疗补助申请被用来说明全州范围内纳洛酮的分布和药剂师全州范围内纳洛酮的使用情况。计算各县发放纳洛酮的药店占比。经过培训的药房工作人员完成了一份项目评估表。关于教学质量和培训师达到既定目标的能力的问题用李克特量表进行评分。结果：2016年上半年，100家门诊药房共收到808份纳洛酮医疗补助申请，比2014年增加了9倍。“A Dose of R(x) reality”培训项目评估表明，参与者认为培训没有偏见，并达到了所有既定目标（李克特量表4分）。结论：多管齐下的国家和社区合作方法成功地克服了与纳洛酮药房分销相关的障碍和挑战，并确保了其作为城乡社区纳洛酮获取的有效途径的成功。(C) 2017美国药剂师协会(R)。Elsevier Inc.出版。版权所有。
Objective: To highlight New Mexico's multifaceted approach to widespread pharmacy naloxone distribution and to share the interventions as a tool for improving pharmacy-based naloxone practices in other states.Setting: New Mexico had the second highest drug overdose death rate in 2014 of which 53% were related to prescription opioids. Opioid overdose death is preventable through the use of naloxone, a safe and effective medication that reverses the effects of prescription opioids and heroin. Pharmacists can play an important role in providing naloxone to individuals who use prescription opioids.Practice description: Not applicable.Practice innovations: Not applicable.Interventions: A multifaceted approach was utilized in New Mexico from the top down with legislative passage of provisions for a statewide standing order and New Mexico Department of Health support for pharmacy-based naloxone delivery. A bottom up approach was also initiated with the development and implementation of a training program for pharmacists and pharmacy technicians.Evaluation: Naloxone Medicaid claims were used to illustrate statewide distribution and utilization of the pharmacist statewide standing order for naloxone. Percent of pharmacies dispensing naloxone in each county were calculated. Trained pharmacy staff completed a program evaluation form. Questions about quality of instruction and ability of trainer to meet stated objectives were rated on a Likert scale.Results: There were 808 naloxone Medicaid claims from 100 outpatient pharmacies during the first half of 2016, a 9-fold increase over 2014. The "A Dose of R(x)eality" training program evaluation indicated that participants felt the training was free from bias and met all stated objectives (4 out of 4 on Likert scale).Conclusions: A multi-pronged approach coupling state and community collaboration was successful in overcoming barriers and challenges associated with pharmacy naloxone distribution and ensured its success as an effective avenue for naloxone acquisition in urban and rural communities. (C) 2017 American Pharmacists Association (R). Published by Elsevier Inc. All rights reserved.