Pharmacy naloxone codispensing: A mixed methods study of practices and perspectives under a statewide standing order program.
Pharmacy naloxone codispensing: A mixed methods study of practices and perspectives under a statewide standing order program.
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DOI：
10.1016/j.japh.2022.03.015
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发表时间：
2022-09
影响因子：
2.1
通讯作者：
Walley, Alexander Y.
中科院分区：
文献类型：
--
作者：
Pollini, Robin A.;Slocum, Susannah;Ozga, Jenny E.;Joyce, Rebecca;Xuan, Ziming;Green, Traci C.;Walley, Alexander Y.
在之前在马萨诸塞州进行的全州范围内的纳洛酮采购试验中，我们根据患者的要求，在该州的纳洛酮常备订单（NSO）计划下，记录了高水平的纳洛酮可及性。对于降低过量死亡率同样重要的是，通过在药店与阿片类药物处方和注射器一起配药，扩大纳洛酮的可及性。本研究的目的是了解从药剂师的角度纳洛酮共同配药在马萨诸塞州的NSO计划。混合方法设计涉及三个焦点小组和定量调查。焦点小组（n = 27）和调查（n = 339）的参与者都是有执照的马萨诸塞州药剂师。在三个独立的药剂师专业会议上进行了焦点小组讨论。这项调查是对马萨诸塞州400家连锁和独立零售药店进行分层随机抽样调查的。所有数据收集于2018年9月至2019年11月之间。目前的政策，做法，以及对阿片类药物过量风险患者纳洛酮共同配药的态度。大多数药剂师（69%）报告说，他们和/或他们的药房促进阿片类药物处方的共同配药。大多数提倡纳洛酮共同配药的人对处方高阿片类药物剂量的患者也是如此（80%）；更少的人提倡共同配药的患者也开苯二氮卓类药物（20%）。共同配药的促进因素是药剂师和处方者之间既存的关系；强制患者/药剂师咨询；对所有符合特定标准的患者推广纳洛酮。共同配药的障碍是药剂师担心发起关于纳洛酮的对话会冒犯患者；技术人员培训不足；工作流程和资源约束；以及对纳洛酮的误解。我们发现连锁药店和独立药店的结果没有实质性差异。我们记录了马萨诸塞州药房纳洛酮共同配药的几个促进因素和障碍。适合干预的领域包括增加对一线药学技术人员的培训，对阿片类药物处方患者的强制性药剂师咨询，工作流程重组以及解决药剂师端耻辱感问题。
In a prior statewide naloxone purchase trial conducted in Massachusetts, we documented high levels of naloxone accessibility, upon patient request, under the state’s naloxone standing order (NSO) program. Equally important for reducing overdose mortality rates is expanding naloxone access via co-dispensing alongside opioid prescription and syringe purchases at pharmacies. The purpose of this study was to understand naloxone co-dispensing from the perspective of pharmacists under the Massachusetts NSO program. Mixed methods design involving three focus groups and a quantitative survey. Participants in both the focus groups (n = 27) and survey (n = 339) were licensed Massachusetts pharmacists. Focus groups were conducted at three separate professional conferences for pharmacists. The survey was conducted using a stratified random sample of 400 chain and independent retail pharmacies across Massachusetts. All data were collected between September 2018 and November 2019. Current policies, practices, and attitudes regarding naloxone co-dispensing for patients at risk of opioid overdose. Most pharmacists (69%) reported that they and/or their pharmacy promoted co-dispensing alongside opioid prescriptions. A majority promoting naloxone co-dispensing did so for patients prescribed high opioid dosages (80%); fewer promoted co-dispensing for patients also prescribed benzodiazepines (20%). Facilitators to co-dispensing were pre-existing relationships between pharmacists and prescribers; mandatory patient/pharmacist consultation; and universal naloxone promotion to all patients meeting certain criteria. Barriers to co-dispensing were pharmacists’ concerns about offending patients by initiating a conversation about naloxone; insufficient technician training; workflow and resource constraints; and misconceptions surrounding naloxone. We found no substantive differences in outcomes between chain and independent pharmacies. We documented several facilitators and barriers to naloxone co-dispensing in Massachusetts pharmacies. Areas amenable to intervention include increased training for frontline pharmacy technicians, mandatory pharmacist consultation for opioid-prescribed patients, workflow reorganization, and addressing stigma concerns on the pharmacist end.
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DOI：
10.1016/j.japh.2017.01.017
发表时间：
2017-03-01
影响因子：
2.1
作者：
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DOI：
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发表时间：
2017-03-01
影响因子：
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影响因子：
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