School of Social Work, Adelphi, University, Garden City, NY, USA; Center for the Psychosocial Study, of Health and Illness, Columbia, University, New York, NY, USA.
Risk Manag Healthc Policy. 2011;4:97-105. doi: 10.2147/RMHP.S24068. Epub 2011 Sep 6.
This article proposes and develops novel components of community-oriented programs for creating and affording access to safe medication dispensing centers in existing retail pharmacies and in permanent or travelling pharmacy clinics that are guarded by assigned or off-duty police officers. Pharmacists at these centers would work with police, medical providers, social workers, hospital administrators, and other professionals in: planning and overseeing the safe storage of controlled substance medications in off-site community safe-deposit boxes; strengthening communication and cooperation with the prescribing medical provider; assisting the prescribing medical provider in patient monitoring (checking the state prescription registry, providing pill counts and urine samples); expanding access to lower-cost, and in some cases, abuse-resistant formulations of controlled substance medications; improving transportation access for underserved patients and caregivers to obtain prescriptions; and integrating community agencies and social networks as resources for patient support and monitoring. Novel components of two related community-oriented programs, which may be hosted outside of safe medication dispensing centers, are also suggested and described: (1) developing medication purchasing cooperatives (ie, to help patients, families, and health institutions afford the costs of medications, including tamper-or abuse-resistant/deterrent drug formulations); and (2) expanding the role of inner-city methadone maintenance treatment programs in palliative care (ie, to provide additional patient monitoring from a second treatment team focusing on narcotics addiction, and potentially, to serve as an untapped source of opioid medication for pain that is less subject to abuse, misuse, or diversion).
本文提出并开发了新的社区导向项目的组成部分，以创建和提供安全的配药中心，这些中心可以在现有的零售药店和由指定或下班警察守卫的永久性或巡回药房诊所中设立。这些中心的药剂师将与警察、医疗服务提供者、社会工作者、医院管理人员和其他专业人员合作：规划和监督在社区外的安全保管箱中安全储存管制药物；加强与处方医疗服务提供者的沟通与合作；协助处方医疗服务提供者对患者进行监测（检查州处方登记处，提供药丸计数和尿液样本）；扩大获得低成本且在某些情况下具有防滥用制剂的管制药物的机会；改善医疗服务不足的患者和护理人员获得处方的交通便利性；并整合社区机构和社交网络，作为患者支持和监测的资源。还提出并描述了两个相关社区导向项目的新组成部分，这些项目可能在安全配药中心之外举办：（1）建立药物购买合作社（即，帮助患者、家庭和医疗机构负担药物成本，包括篡改或防滥用/抗滥用药物制剂）；（2）扩大市中心美沙酮维持治疗方案在姑息治疗中的作用（即，提供第二个专注于麻醉品成瘾的治疗团队的额外患者监测，并且可能成为滥用、误用或转移风险较低的疼痛阿片类药物的潜在来源）。
