Indiana University School of Public Health-Bloomington, 1025 E. 7th St., Bloomington, IN 47405, USA; Rural Center for AIDS/STD Prevention, Indiana University, 801 E. 7th St., Bloomington, IN 47405, USA.
Indiana University School of Public Health-Bloomington, 1025 E. 7th St., Bloomington, IN 47405, USA; Indiana Prevention Research Center, Indiana University,501 N. Morton St. Suite 110, Bloomington, IN 47404, USA; Institute for Research on Addictive Behavior, Indiana University, 501 N. Morton St. Suite 104, Bloomington, IN 47404, USA.
Drug Alcohol Depend. 2018 Jul 1;188:187-192. doi: 10.1016/j.drugalcdep.2018.03.032. Epub 2018 Apr 26.
While naloxone, the overdose reversal medication, has been available for decades, factors associated with its availability through pharmacies remain unclear. Studies suggest that policy and pharmacist beliefs may impact availability. Indiana passed a standing order law for naloxone in 2015 to increase access to naloxone.
To identify factors associated with community pharmacy naloxone stocking and dispensing following the enactment of a statewide naloxone standing order.
A 2016 cross-sectional census of Indiana community pharmacists was conducted following a naloxone standing order. Community, pharmacy, and pharmacist characteristics, and pharmacist attitudes about naloxone dispensing, access, and perceptions of the standing order were measured. Modified Poisson and binary logistic regression models attempted to predict naloxone stocking and dispensing, respectively.
Over half (58.1%) of pharmacies stocked naloxone, yet 23.6% of pharmacists dispensed it. Most (72.5%) pharmacists believed the standing order would increase naloxone stocking, and 66.5% believed it would increase dispensing. Chain pharmacies were 3.2 times as likely to stock naloxone. Naloxone stocking was 1.6 times as likely in pharmacies with more than one full-time pharmacist. Pharmacies where pharmacists received naloxone continuing education in the past two years were 1.3 times as likely to stock naloxone. The attempted dispensing model yielded no improvement over the constant-only model.
Pharmacies with larger capacity took advantage of the naloxone standing order. Predictors of pharmacist naloxone dispensing should continue to be explored to maximize naloxone access.
尽管纳洛酮（一种用于逆转过量用药的药物）已经问世几十年，但通过药店获得该药的相关因素仍不清楚。有研究表明，政策和药剂师的信念可能会影响纳洛酮的可获得性。印第安纳州于 2015 年通过了一项纳洛酮常备处方法，以增加纳洛酮的可获得性。
确定在全州范围内实施纳洛酮常备处方后，社区药店储备和配药纳洛酮的相关因素。
在实施纳洛酮常备处方后，于 2016 年对印第安纳州社区药剂师进行了横断面普查。测量了社区、药店和药剂师的特征，以及药剂师对纳洛酮配药、获取和对常备处方的看法。采用修正泊松和二项逻辑回归模型分别尝试预测纳洛酮的储备和配药情况。
超过一半（58.1%）的药店储备了纳洛酮，但只有 23.6%的药剂师配药。大多数（72.5%）药剂师认为常备处方会增加纳洛酮的储备，66.5%的药剂师认为会增加配药。连锁药店储备纳洛酮的可能性是其他药店的 3.2 倍。拥有多名全职药剂师的药店储备纳洛酮的可能性是其他药店的 1.6 倍。在过去两年中接受过纳洛酮继续教育的药店储备纳洛酮的可能性是其他药店的 1.3 倍。尝试的配药模型并未优于常数模型。
具有较大储备能力的药店利用了纳洛酮常备处方。应继续探索药剂师配药纳洛酮的预测因素，以最大限度地增加纳洛酮的可获得性。
