Assessing pharmacy-based naloxone access using an innovative purchase trial methodology.
Assessing pharmacy-based naloxone access using an innovative purchase trial methodology.
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使用创新的购买试验方法评估基于药房的纳洛酮访问。
DOI：
10.1016/j.japh.2020.05.016
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发表时间：
2020-11
期刊：
影响因子：
--
通讯作者：
Walley AY
中科院分区：
文献类型：
--
作者：
Pollini RA;Joyce R;Ozga-Hess JE;Xuan Z;Green TC;Walley AY
马萨诸塞州是最早允许长期订单的州之一，以促进基于药房的纳洛酮购买和减少阿片类药物过量死亡。我们进行了一项独特的购买试验，以确定马萨诸塞州长期订购纳洛酮的有效措施，使用来自两个高优先级人群的购买者，以确定使用非法阿片类药物的人是否比其他潜在购买者更难获得纳洛酮。从全州范围内的名单中随机抽取了200家零售药店。每个药店都进行了两次购买尝试-一次是由使用非法阿片类药物的人（PWUIO）进行的，另一次是由未使用非法阿片类药物但与阿片类药物过量风险相关的潜在旁观者进行的。采购于二零一八年五月至二零一九年四月期间根据详细采购方案进行。配对分析被用来确定购买结果和经验的购买者类型的统计学显着差异。总体而言，397次购买尝试中有322次（81%）成功，PWUIO和旁观者之间没有显著差异（p= 0.221）。大多数购买（93%）导致获得单步鼻纳洛酮（NARCAN;中位数成本为133.38美元）。40%的购买包括国家规定的口头咨询，PWUIO接受咨询的可能性明显低于旁观者（30%对51%，p<0.001）。购买失败的常见原因是没有储存纳洛酮（47%），价格> 150美元（25%）和需要处方（15%）。连锁药店比独立药店更有可能销售纳洛酮（86%对53%，p<0.001）。我们记录了PWUIO和旁观者获得纳洛酮的高水平，这表明马萨诸塞州可以作为寻求改善基于药房的纳洛酮获得的州的典范。额外的实施工作应侧重于扩大独立药店的可用性，并支持药店主动向PWUIO和其他高风险人群提供纳洛酮。
Massachusetts was among the first states to allow standing orders to facilitate pharmacy-based naloxone purchase and reduce opioid overdose deaths. We conducted a unique purchase trial to establish a valid measure of standing order naloxone in Massachusetts, using purchasers from two high priority populations to determine whether naloxone is less accessible to those who use illicit opioids than other potential purchasers. A random sample of 200 retail pharmacies was selected from a statewide list. Each pharmacy underwent two purchase attempts - one by a person who used illicit opioids (PWUIO) and one by a potential bystander who did not use illicit opioids but had a relationship with someone at risk of opioid overdose. Purchases were conducted in accordance with a detailed purchase protocol between May 2018 and April 2019. Matched pairs analysis was used to identify statistically significant differences in purchase outcomes and experiences by purchaser type. Overall, 322 of 397 purchase attempts (81%) were successful, with no significant difference between PWUIO and bystanders (p=.221). Most purchases (93%) resulted in acquisition of single-step nasal naloxone (NARCAN; median cost $133.38). Forty percent of purchases included state-mandated verbal counseling, and PWUIO were significantly less likely to receive counseling than bystanders (30% vs. 51%, p<.001). Common reasons for failed purchase were not stocking naloxone (47%), price >$150 (25%), and requiring a prescription (15%). Chain pharmacies were significantly more likely to sell naloxone than independent pharmacies (86% vs. 53%, p<.001). We documented high levels of naloxone access for both PWUIO and bystanders, suggesting Massachusetts could serve as a model for states seeking to improve pharmacy-based naloxone access. Additional implementation efforts should focus on expanding availability at independent pharmacies and supporting pharmacies in proactively offering naloxone to PWUIO and other high-risk individuals.
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DOI：
10.1111/add.13265
发表时间：
2016-05
期刊：
Addiction (Abingdon, England)
影响因子：
--
作者：
Bird SM;McAuley A;Perry S;Hunter C
通讯作者：
Hunter C
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：
4.2
作者：
Behar, Emily;Santos, Glenn-Milo;Coffin, Phillip O.
通讯作者：
Coffin, Phillip O.