Nielsen Suzanne, Van Hout Marie Claire
National Drug and Alcohol Research Centre, University of New South Wales, Australia; Drug and Alcohol Services, South Eastern Sydney Local Health District, Australia.
School of Health Sciences, Waterford Institute of Technology, Ireland.
Int J Drug Policy. 2016 Jun;32:24-33. doi: 10.1016/j.drugpo.2016.02.006. Epub 2016 Feb 15.
There is growing evidence that expanded supply of take-home naloxone to prevent opioid overdose deaths is needed. Potential routes for expansion of naloxone provision include through community pharmacies. The aim of this scoping review is to establish what is known about community pharmacy supply of naloxone, in light of unique challenges and opportunities present in pharmacy settings. A scoping review methodology was employed using the six stage iterative process advocated by Arksey and O'Malley (2005) and Levac et al. (2010). Searches used key words and terms such as 'naloxone'; 'overdose prevention/drug overdose/opiate overdose'; 'community/retail pharmacy'; 'pharmacist/pharmacy/community pharmacy/pharmaceutical services'; 'professional practice/role'; 'community care'; attitude of health personnel'; 'training/supply/cost'. Appropriate search terms were selected for each database. After initial exploratory searches, comprehensive searches were conducted with Cochrane Database of Systematic Reviews, Medline, Medline in Process, Embase, PsycINFO and CINAHL. Eligibility criteria centered on whether studies broadly described supply of naloxone in community pharmacy or had content relating to community pharmacy supply. The search identified 95 articles, of which 16 were related to pharmacy supply of naloxone. Five themes were presented after initial review of the data and consultation with the project Expert Group, and are; 'Pharmacists Perceptions of Naloxone: Facilitators and Barriers', 'Patient Populations: Identification and Recruitment', 'Supply Systems and Cost', 'Legal Issues', and 'Training of Pharmacists and Community Pharmacy Naloxone Recipients'. Findings from this scoping review suggest that community pharmacy based supply of take-home naloxone warrants the community pharmacy based route for distribution of take home naloxone provision warrants further consideration and development. Existing strengths include a range of established supply models, and training curricula, few direct concerns regarding legal liability of pharmacists in the supply of naloxone (once legal supply systems have been established) and the wide range of potential identifiable patient populations, which include pain patients that may not be in contact with existing naloxone supply programmes.
越来越多的证据表明，需要扩大纳洛酮的可带回家供应以预防阿片类药物过量死亡。扩大纳洛酮供应的潜在途径包括通过社区药房。本范围综述的目的是根据药房环境中存在的独特挑战和机遇，确定关于社区药房纳洛酮供应的已知情况。采用了范围综述方法，使用了Arksey和O'Malley（2005年）以及Levac等人（2010年）倡导的六阶段迭代过程。搜索使用了关键词和术语，如“纳洛酮”；“过量预防/药物过量/阿片类药物过量”；“社区/零售药房”；“药剂师/药房/社区药房/药学服务”；“专业实践/角色”；“社区护理”；“卫生人员的态度”；“培训/供应/成本”。为每个数据库选择了适当的搜索词。在初步探索性搜索之后，对Cochrane系统评价数据库、Medline、Medline在研、Embase、PsycINFO和CINAHL进行了全面搜索。纳入标准集中在研究是否广泛描述了社区药房中纳洛酮的供应情况或是否有与社区药房供应相关的内容。搜索识别出95篇文章，其中16篇与纳洛酮的药房供应有关。在对数据进行初步审查并与项目专家组协商后，呈现了五个主题，分别是：“药剂师对纳洛酮的看法：促进因素和障碍”、“患者群体：识别和招募”、“供应系统和成本”、“法律问题”以及“药剂师和社区药房纳洛酮接受者的培训”。本范围综述的结果表明，基于社区药房的可带回家纳洛酮供应值得进一步考虑和发展。现有的优势包括一系列既定的供应模式和培训课程，在纳洛酮供应方面对药剂师法律责任的直接担忧较少（一旦建立合法供应系统），以及广泛的潜在可识别患者群体，其中包括可能未与现有纳洛酮供应计划接触的疼痛患者。
