University of Kentucky HealthCare, Lexington, KY, USA.
Ann Pharmacother. 2014 May;48(5):601-6. doi: 10.1177/1060028014523730. Epub 2014 Feb 12.
Deaths related to opioid overdose have increased in the past decade. Community-based pharmacy practitioners have worked toward overcoming logistic and cultural barriers to make naloxone distribution for overdose prevention a standard and accepted practice.
To describe outpatient naloxone dispensing practices, including methods by which practitioners implement dispensing programs, prescribing patterns that include targeted patient populations, barriers to successful implementation, and methods for patient education.
Interviews were conducted with providers to obtain insight into the practice of dispensing naloxone. Practitioners were based in community pharmacies or clinics in large metropolitan cities across the country.
It was found that 33% of participating pharmacists practice in a community-pharmacy setting, and 67% practice within an outpatient clinic-based location. Dispensing naloxone begins by identifying patient groups that would benefit from access to the antidote. These include licit users of high-dose prescription opioids (50%) or injection drug users and abusers of prescription medications (83%). Patients were identified through prescription records or provider screening tools. Dispensing naloxone required a provider's prescription in 5 of the 6 locations identified. Only 1 pharmacy was able to exercise pharmacist prescriptive authority within their practice.
Outpatient administration of intramuscular and intranasal naloxone represents a means of preventing opioid-related deaths. Pharmacists can play a vital role in contacting providers, provision of products, education of patients and providers, and dissemination of information throughout the community. Preventing opioid overdose-related deaths should become a major focus of the pharmacy profession.
在过去的十年中，与阿片类药物过量相关的死亡人数有所增加。社区药房从业者已经努力克服物流和文化障碍，使纳洛酮分发成为预防过量的标准和可接受的做法。
描述门诊纳洛酮配药的做法，包括从业者实施配药计划的方法、包括目标患者群体的处方模式、成功实施的障碍以及患者教育的方法。
对提供者进行访谈，以了解配药纳洛酮的做法。从业者的工作地点位于全国大城市的社区药房或诊所。
发现 33%的参与药剂师在社区药房环境中执业，67%的人在门诊诊所执业。纳洛酮的配药始于确定受益于获得解毒剂的患者群体。这些包括合法使用高剂量处方阿片类药物（50%）或注射药物使用者和处方药物滥用者（83%）的患者。通过处方记录或提供者筛选工具来识别患者。在确定的 6 个地点中的 5 个地点，需要提供者的处方才能配药纳洛酮。只有 1 家药店能够在其执业范围内行使药剂师的处方权。
肌肉内和鼻内给予纳洛酮是预防阿片类药物相关死亡的一种手段。药剂师可以在联系提供者、提供产品、对患者和提供者进行教育以及在整个社区传播信息方面发挥重要作用。预防阿片类药物过量相关死亡应成为药学专业的主要重点。
