Morton Kate J, Harrand Brianna, Floyd Carly Cloud, Schaefer Craig, Acosta Julie, Logan Bridget Claire, Clark Karen
J Am Pharm Assoc (2003). 2017 Mar-Apr;57(2S):S99-S106.e5. doi: 10.1016/j.japh.2017.01.017.
To highlight New Mexico's multifaceted approach to widespread pharmacy naloxone distribution and to share the interventions as a tool for improving pharmacy-based naloxone practices in other states.
New Mexico had the second highest drug overdose death rate in 2014 of which 53% were related to prescription opioids. Opioid overdose death is preventable through the use of naloxone, a safe and effective medication that reverses the effects of prescription opioids and heroin. Pharmacists can play an important role in providing naloxone to individuals who use prescription opioids.
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A multifaceted approach was utilized in New Mexico from the top down with legislative passage of provisions for a statewide standing order and New Mexico Department of Health support for pharmacy-based naloxone delivery. A bottom up approach was also initiated with the development and implementation of a training program for pharmacists and pharmacy technicians.
Naloxone Medicaid claims were used to illustrate statewide distribution and utilization of the pharmacist statewide standing order for naloxone. Percent of pharmacies dispensing naloxone in each county were calculated. Trained pharmacy staff completed a program evaluation form. Questions about quality of instruction and ability of trainer to meet stated objectives were rated on a Likert scale.
There were 808 naloxone Medicaid claims from 100 outpatient pharmacies during the first half of 2016, a 9-fold increase over 2014. The "A Dose of Reality" training program evaluation indicated that participants felt the training was free from bias and met all stated objectives (4 out of 4 on Likert scale).
A multi-pronged approach coupling state and community collaboration was successful in overcoming barriers and challenges associated with pharmacy naloxone distribution and ensured its success as an effective avenue for naloxone acquisition in urban and rural communities.
强调新墨西哥州在广泛分发药房纳洛酮方面的多方面举措，并分享这些干预措施，作为改善其他州基于药房的纳洛酮实践的一种工具。
新墨西哥州在2014年的药物过量死亡率位居全国第二，其中53%与处方阿片类药物有关。通过使用纳洛酮可预防阿片类药物过量死亡，纳洛酮是一种安全有效的药物，可逆转处方阿片类药物和海洛因的作用。药剂师在为使用处方阿片类药物的个人提供纳洛酮方面可发挥重要作用。
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新墨西哥州采用了自上而下的多方面方法，通过立法通过了全州范围内的常备医嘱规定，并得到了新墨西哥州卫生部对基于药房的纳洛酮配送的支持。还启动了自下而上的方法，为药剂师和药房技术人员制定并实施了培训计划。
纳洛酮医疗补助申请用于说明全州范围内纳洛酮的分发和药剂师全州常备医嘱的使用情况。计算每个县分发纳洛酮的药房百分比。经过培训的药房工作人员填写了项目评估表。关于教学质量和培训师实现既定目标能力的问题采用李克特量表进行评分。
2016年上半年，来自100家门诊药房的纳洛酮医疗补助申请有808份，比2014年增长了9倍。“一剂现实”培训项目评估表明，参与者认为培训没有偏见，达到了所有既定目标（李克特量表评分为4分中的4分）。
州与社区合作相结合的多管齐下方法成功克服了与药房纳洛酮分发相关的障碍和挑战，并确保其成为城乡社区获取纳洛酮的有效途径。
