Feasibility of a pharmacy-based overdose prevention program in rural/suburban NY

纽约州农村/郊区基于药房的药物过量预防计划的可行性

基本信息

项目摘要

The purpose of this mixed-methods exploratory study is to (1) investigate the support and diffusion of naloxone pharmacy services that utilize a standing order, and (2) assess feasibility of an expanded public health role for naloxone-registered pharmacists to help increase uptake of pharmacy-acquired naloxone in rural /suburban New York (NY). The U.S. opioid overdose crisis has led to legislation in 49 states allowing naloxone (i.e., opioid overdose reversal medication) to be dispensed through a non-patient specific prescription or “standing order”. In New York State (NYS), over 2,600 pharmacies are registered to participate in the Opioid Overdose Prevention Program (OOPP) which allows use of a standing order to dispense naloxone. Yet, pilot data as well as anecdotal evidence suggests that pharmacy-acquired naloxone is infrequent in NY, and either non-existent or limited in suburban/rural counties where burden of opioid-related overdose deaths is highest. Recent reports have identified pharmacy reimbursement challenges, patient affordability, and patient-anticipated stigma dampening naloxone demand as ongoing barriers – even where extensive pharmacy-targeted overdose prevention training and education have taken place. The goal of this study is to explore barriers (eg. opioid- related stigma) and facilitators (eg. use of a state-funded co-pay reimbursement program) of pharmacy naloxone services in NY suburban/rural counties where pharmacy dispensation is low or non-existent, and overdose rates are high. In addition, we will explore pharmacist interest in coupling naloxone services with other non-stigmatizing pharmacy services to help increase uptake and support of pharmacy naloxone services (a successful stigma- reducing intervention from our prior work in the HIV arena). The diffusion of innovation provides a theoretical framework to examine adoption and rejection of pharmacy naloxone services. Specifically, we will identify pharmacist/pharmacy characteristics, experiences, and practices associated with: (i) naloxone registration status (Aim 1a), (ii) support for pharmacy naloxone services, and (iii) support for coupling naloxone with other non- stigmatizing pharmacy services (Aim 1b) among 1,000 naloxone-registered and non-registered pharmacists. We will also conduct in-depth interviews to contextualize the individual-, pharmacy-, and policy-level barriers/facilitators of pharmacy naloxone services among key stakeholders: (a) pharmacists (n=24); (b) opioid- related ED patients (n=20); and (c) community advocates/health officials (n=16) (Aim 2). We will target 8 counties with the highest opioid overdose rates in NYS to administer a pharmacist computer-assisted phone survey (online, and/or in-person also available), and 2 of those counties will be selected to conduct in-depth interviews where our research capacity has been established. Survey and qualitative data will be analyzed and triangulated for final data interpretation. Proposal significance and innovation is high given: (1) the opioid crisis and similar pharmacy naloxone policy across U.S., (2) the generalizability gained by targeting geographically and racially diverse non-urban areas, and (3) the potential for a pharmacy-based intervention that addresses stigma to follow.
本混合方法探索性研究的目的是(1)研究纳洛酮的支持和扩散 利用长期订单的药房服务;(2)评估扩大公共卫生作用的可行性, 纳洛酮注册药剂师,以帮助增加在农村/郊区新的药房获得纳洛酮的吸收 约克(纽约州)。美国阿片类药物过量危机导致49个州立法允许纳洛酮(即,阿片 过量逆转药物)通过非患者特定处方或“长期订单”分配。在 在纽约州(NYS),超过2,600家药店注册参与阿片类药物过量预防 允许使用长期订单分配纳洛酮的程序(OSTO)。然而,试点数据以及轶事 有证据表明,在纽约,药物获得性纳洛酮并不常见, 阿片类药物相关过量死亡负担最高的郊区/农村县。最近的报告 确定的药房报销挑战、患者负担能力和患者预期的耻辱 抑制纳洛酮需求作为持续的障碍-即使在广泛的药物靶向过量 开展了预防培训和教育。本研究的目的是探索障碍(如。阿片类药物- 相关污名)和促进者(例如,使用国家资助的共同支付报销计划)的药房纳洛酮 纽约郊区/农村县的服务,这些县的药房分配率低或不存在, 很高。此外,我们将探讨药剂师的兴趣,将纳洛酮服务与其他非污名化 药房服务,以帮助增加吸收和支持药房纳洛酮服务(一个成功的耻辱, 减少我们先前在HIV竞技场工作中的干预)。创新的扩散提供了一个理论上的 框架,以审查通过和拒绝药房纳洛酮服务。具体来说,我们将确定 药剂师/药房特征、经验和实践与:(i)纳洛酮注册状态 (Aim(二)支持纳洛酮药房服务,以及(三)支持纳洛酮与其他非 在1,000名纳洛酮注册和非注册药剂师中污名化药房服务(目标1b)。 我们还将进行深入访谈,以了解个人,药房和政策层面的背景 关键利益相关者中纳洛酮药房服务的障碍/促进因素:(a)药剂师(n=24);(B)阿片类药物- 相关艾德患者(n=20);和(c)社区倡导者/卫生官员(n=16)(目标2)。我们将针对8个县 纽约州阿片类药物过量率最高, (也可在线和/或面对面),并将选择其中2个县进行深入访谈 我们的研究能力已经建立。将对调查和定性数据进行分析和三角测量 最终数据解释。建议的意义和创新性很高:(1)阿片类药物危机和类似 美国的纳洛酮药物政策,(2)通过地理和种族上的定位获得的普遍性 不同的非城市地区,(3)基于药物的干预,解决耻辱的潜力。

项目成果

期刊论文数量(2)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
Rural and small metro area naloxone-dispensing pharmacists' attitudes, experiences, and support for a frontline public health pharmacy role to increase naloxone uptake in New York State, 2019.
  • DOI:
    10.1016/j.jsat.2021.108372
  • 发表时间:
    2021-10
  • 期刊:
  • 影响因子:
    3.9
  • 作者:
    Tofighi B;Lekas HM;Williams SZ;Martino D;Blau C;Lewis CF
  • 通讯作者:
    Lewis CF
Internet use and uptake of a web-based prevention and risk reduction intervention for persons who use drugs in New York City - WebHealth4Us study (2013-2016).
  • DOI:
    10.1080/08897077.2022.2028701
  • 发表时间:
    2022
  • 期刊:
  • 影响因子:
    3.5
  • 作者:
    Lewis, Crystal Fuller;Williams, Sharifa Z.;Tofighi, Babak;Lekas, Helen-Maria;Joseph, Adriana;Rivera, Alexis;Amesty, Silvia C.
  • 通讯作者:
    Amesty, Silvia C.
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CRYSTAL FULLER LEWIS其他文献

CRYSTAL FULLER LEWIS的其他文献

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{{ truncateString('CRYSTAL FULLER LEWIS', 18)}}的其他基金

Leveraging social determinants via artificial intelligence and peer coaching to address racial disparities in primary care among people who use opioids
通过人工智能和同伴辅导利用社会决定因素来解决阿片类药物使用者初级保健中的种族差异
  • 批准号:
    10829058
  • 财政年份:
    2023
  • 资助金额:
    $ 22.42万
  • 项目类别:
Feasibility of pharmacy-delivered patient navigation + virtual buprenorphine + HIV services
药房提供的患者导航虚拟丁丙诺啡 HIV 服务的可行性
  • 批准号:
    10675653
  • 财政年份:
    2022
  • 资助金额:
    $ 22.42万
  • 项目类别:
Feasibility of pharmacy-delivered patient navigation + virtual buprenorphine + HIV services
药房提供的患者导航虚拟丁丙诺啡 HIV 服务的可行性
  • 批准号:
    10554018
  • 财政年份:
    2022
  • 资助金额:
    $ 22.42万
  • 项目类别:
Feasibility of a pharmacy-based overdose prevention program in rural/suburban NY
纽约州农村/郊区基于药房的药物过量预防计划的可行性
  • 批准号:
    9979522
  • 财政年份:
    2020
  • 资助金额:
    $ 22.42万
  • 项目类别:
Exploratory study of drug user health-related internet and mobile technology use
吸毒者健康相关互联网和移动技术使用的探索性研究
  • 批准号:
    8512442
  • 财政年份:
    2013
  • 资助金额:
    $ 22.42万
  • 项目类别:
Post exposure prophylaxis among IDU syringe customers-Pharmacy pilot intervention
IDU 注射器顾客的暴露后预防——药房试点干预
  • 批准号:
    8679202
  • 财政年份:
    2010
  • 资助金额:
    $ 22.42万
  • 项目类别:
Post exposure prophylaxis among IDU syringe customers-Pharmacy pilot intervention
IDU 注射器顾客的暴露后预防——药房试点干预
  • 批准号:
    8304340
  • 财政年份:
    2010
  • 资助金额:
    $ 22.42万
  • 项目类别:
Post exposure prophylaxis among IDU syringe customers-Pharmacy pilot intervention
IDU 注射器顾客的暴露后预防——药房试点干预
  • 批准号:
    8133982
  • 财政年份:
    2010
  • 资助金额:
    $ 22.42万
  • 项目类别:
Post exposure prophylaxis among IDU syringe customers-Pharmacy pilot intervention
IDU 注射器顾客的暴露后预防——药房试点干预
  • 批准号:
    8513957
  • 财政年份:
    2010
  • 资助金额:
    $ 22.42万
  • 项目类别:
Post exposure prophylaxis among IDU syringe customers-Pharmacy pilot intervention
IDU 注射器顾客的暴露后预防——药房试点干预
  • 批准号:
    8440922
  • 财政年份:
    2010
  • 资助金额:
    $ 22.42万
  • 项目类别:

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