Varisco Tyler J, Ogunsanya Motolani E, Barner Jamie C, Fleming Marc L
J Am Pharm Assoc (2003). 2017 Mar-Apr;57(2S):S51-S62. doi: 10.1016/j.japh.2017.01.020.
To determine (1) pharmacists' perceptions of how rescheduling of hydrocodone combination products (HCPs) from Drug Enforcement Agency (DEA) Schedule III to DEA Schedule II has influenced prescription volume and revenue, pharmacy workflow management, and patient outcomes; and (2) whether perceptions differed between pharmacists who support versus those who oppose HCP rescheduling.
A cross-sectional mail survey.
Texas community pharmacies from October to December 2015.
One thousand randomly selected, registered Texas community pharmacists drawn from the Texas State Board of Pharmacy registry.
Pharmacists' perceptions, measured on a 5-point Likert scale of HCP rescheduling and its impact on prescription volume and revenue, workflow management, and patient outcomes. Measures were developed specifically for this study.
The response rate was 17% (n = 164). The majority of pharmacists (70.4%) supported HCP rescheduling. More than 80% of respondents perceived that the volume of 2 alternative pain medications-tramadol (DEA Schedule IV) and acetaminophen with codeine (DEA Schedule III) prescriptions dispensed-either "increased" or "significantly increased" (82.0% and 85.8%, respectively) following rescheduling. Overall, pharmacists who opposed rescheduling were significantly more likely to report negative perceptions regarding revenue (P = 0.0142), inventory management (P = 0.0024), and drug shortages (P = 0.0005) than those who supported rescheduling. However, pharmacists who supported rescheduling had more positive perceptions about electronic prescribing (P <0.0115), patient safety (P <0.001), drug abuse (P <0.0001), and legitimate use (P <0.0001).
Results showed that legislative efforts, such as rescheduling HCPs, influenced pharmacists' perceptions of practice and patient outcomes. Currently, little is known regarding the impact of HCP rescheduling on pharmacy practice. As new laws are passed to address the opioid epidemic in America, more research will be needed to determine whether legislation is an effective means for managing appropriate access to HCPs and other narcotic analgesics.
确定（1）药剂师对于将氢可酮复方制剂（HCPs）从美国药品管理局（DEA）的III类重新划分为II类这一举措如何影响处方量、收入、药房工作流程管理以及患者结局的看法；以及（2）支持与反对HCP重新分类的药剂师之间的看法是否存在差异。
横断面邮寄调查。
2015年10月至12月期间的得克萨斯州社区药房。
从得克萨斯州药房委员会登记处随机抽取的1000名注册得克萨斯州社区药剂师。
药剂师的看法，通过对HCP重新分类及其对处方量、收入、工作流程管理和患者结局的影响采用5点李克特量表进行衡量。这些指标是专门为该研究制定的。
回复率为17%（n = 164）。大多数药剂师（70.4%）支持HCP重新分类。超过80%的受访者认为，重新分类后，两种替代止痛药物——曲马多（DEA IV类）和含可待因对乙酰氨基酚（DEA III类）的处方配药量——“增加”或“显著增加”（分别为82.0%和85.8%）。总体而言，反对重新分类的药剂师比支持重新分类的药剂师更有可能报告对收入（P = 0.0142）、库存管理（P = 0.0024）和药品短缺（P = 0.0005）的负面看法。然而，支持重新分类的药剂师对电子处方（P <0.0115）、患者安全（P <0.001）、药物滥用（P <0.0001）和合法使用（P <0.0001）有更积极的看法。
结果表明，诸如重新划分HCP类别等立法举措影响了药剂师对执业和患者结局的看法。目前，关于HCP重新分类对药房执业的影响知之甚少。随着美国通过新的法律来应对阿片类药物流行问题，将需要更多研究来确定立法是否是管理适当获取HCPs和其他麻醉性镇痛药的有效手段。
