Naloxone Availability in Retail Pharmacies and Neighborhood Inequities in Access
Naloxone Availability in Retail Pharmacies and Neighborhood Inequities in Access
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DOI：
10.1016/j.amepre.2019.11.009
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发表时间：
2020-05-01
影响因子：
5.5
通讯作者：
Lee, Joseph G. L.
中科院分区：
文献类型：
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作者：
Egan, Kathleen L.;Foster, Samantha E.;Lee, Joseph G. L.
简介：本研究检查了北卡罗来纳州纳洛酮常规命令的执行情况，并确定了与药房库存和在常规命令下销售纳洛酮的意愿相关的社区特征。方法：2019年4-6月，完成了神秘来电者方案，以评估(1)北卡罗来纳州药店有纳洛酮可用并愿意在没有处方的情况下分发纳洛酮，(2)与可获得性相关的药房特征，以及(3)在可获得性方面存在社区差异(例如，人口普查区人口规模、密度、种族组成、SES、阿片类药物过量比率和阿片类药物处方率)。采用随机抽样的方法，按北卡罗来纳州参与常备秩序的药店公共名单上的纳入分层，对北卡罗来纳州的连锁药店、独立药店和卫生部门药店进行抽样(2,044家中的161家)。2019年6月，对数据进行了分析。结果：北卡罗来纳州估计有61.7%(95%CI=54.3，68.5)的零售药店在没有处方的情况下提供纳洛酮。独立药店获得纳洛酮的几率低于连锁药店(OR=0.12，95%CI=0.06，0.25)。包括在北卡罗来纳州公开的药房名单上的人获得纳洛酮的几率更大(OR=2.32，95%CI=1.22，4.43)。在拥有公共医疗保险的居民比例较高的社区，纳洛酮的可获得性较低(OR=0.97，95%CI=0.95，0.999)。结论：尽管北卡罗来纳州超过一半的药店参与了纳洛酮的常规订单，但需要努力确定最佳实践，以确保纳洛酮在全州范围内的常规订单的广泛实施。(C)《2019美国预防医学杂志》。爱思唯尔公司出版，版权所有。
Introduction: This study examines the implementation of North Carolina's statewide naloxone standing order and identifies community characteristics associated with pharmacy stocking and willingness to sell naloxone under the standing order.Methods: In April-June 2019, a mystery caller protocol was completed to assess if (1) North Carolina pharmacies had naloxone available and were willing to dispense it without a prescription, (2) pharmacy characteristics associated with availability, and (3) there were neighborhood differences (e.g., Census tract population size, density, racial composition, SES, rates of opioid overdoses, and rates of opioid prescriptions dispensed) in availability. Using random sampling stratified by inclusion on North Carolina's public list of pharmacies participating in the standing order, chain, independent, and health department pharmacies in North Carolina were sampled (n=161 of 2,044). In June 2019, the data were analyzed. Survey weights were utilized to calculate the prevalence of availability, and regression models were conducted to examine associations.Results: An estimated 61.7% (95% CI=54.3, 68.5) of North Carolina retail pharmacies have naloxone available without a prescription. The odds of naloxone availability were lower for independent pharmacies than chains (OR=0.12, 95% CI=0.06, 0.25). Inclusion on North Carolina's public list of pharmacies had greater odds of naloxone availability (OR=2.32, 95% CI=1.22, 4.43). Naloxone availability was lower in communities with higher percentages of residents with public health insurance (OR=0.97, 95% CI=0.95, 0.999).Conclusions: Though more than half of the pharmacies in North Carolina participate in the standing order for naloxone, efforts to identify the best practices for ensuring widespread implementation of statewide standing orders for naloxone are warranted. (C) 2019 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.