Stewart Brittany, Thomas Ronald L, Tutag-Lehr Victoria
Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, 259 Mack Ave, Detroit, MI 48201, United States.
Department of Pediatrics, Wayne State University School of Medicine, 3901 Beaubien, Detroit, MI 48201, United States.
Curr Pharm Teach Learn. 2018 Aug;10(8):1013-1021. doi: 10.1016/j.cptl.2018.05.016. Epub 2018 Jun 7.
Prior to the Michigan naloxone standing order legislation, a sample of Michigan pharmacists was surveyed to (1) identify gaps in knowledge regarding naloxone: (2) assess supportive attitudes towards the standing order and; (3) determine perceived pharmacist roles when providing naloxone.
A 37-item survey was emailed to Michigan Pharmacist Association members (n = 2757), July to August 2016. Responses to knowledge, supportive attitude, and perceived roles items were analyzed using descriptive statistics and logistic regression. Significance set at p < 0.05.
The useable response was 8% (n = 211), 92% white, 54% female, aged 46.5 ± 14.6 years. Knowledge: Eighty-five percent (179/211) agreed laypersons can administer naloxone. Sixty-four percent could identify an opioid overdose and 74% agreed with required pharmacist naloxone education; yet 20% had education. Supportive attitude: Eighty-seven percent (184/211) supported the standing order. Perceived role: Fifty-six percent agreed with responsibility for following patients after providing naloxone. Predictors of agreement were rural practice location (OR = 2.5; 95% CI 1.2-5.0, p = 0.01), and requiring naloxone education (OR = 3.0; 95% CI 1.3-6.8, p = 0.007). Having a Doctor of Pharmacy versus a Bachelor of Science Pharmacy degree decreased odds of agreement by 43.5% (OR = 0.435; 95% CI 0.221-0.857, p = 0.016).
Timing of survey may explain the low number of trained respondents. The increased willingness of BS Pharmacists to follow patients may reflect longer practice and closer community ties. Limitations include low generalizability and small sample.
A small representative sample of Michigan pharmacists is knowledgeable regarding naloxone and has supportive attitudes towards the standing order.
在密歇根州纳洛酮常备医嘱立法之前,对密歇根州的药剂师样本进行了调查,以(1)确定纳洛酮知识方面的差距;(2)评估对常备医嘱的支持态度;以及(3)确定提供纳洛酮时药剂师所感知的角色。
2016年7月至8月,通过电子邮件向密歇根药剂师协会成员(n = 2757)发送了一份包含37个条目的调查问卷。使用描述性统计和逻辑回归分析对知识、支持态度和感知角色条目的回复。显著性设定为p < 0.05。
有效回复率为8%(n = 211),92%为白人,54%为女性,年龄46.5±14.6岁。知识方面:85%(179/211)的人同意非专业人员可以使用纳洛酮。64%的人能够识别阿片类药物过量,74%的人同意药剂师需要接受纳洛酮教育;然而,只有20%的人接受过相关教育。支持态度方面:87%(184/211)的人支持常备医嘱。感知角色方面:56%的人同意在提供纳洛酮后有责任跟踪患者。同意的预测因素包括农村执业地点(OR = 2.5;95% CI 1.2 - 5.0,p = 0.01)以及需要接受纳洛酮教育(OR = 3.0;95% CI 1.3 - 6.8,p = 0.007)。拥有药学博士学位而非理学学士药学学位会使同意的几率降低43.5%(OR = 0.435;95% CI 0.221 - 0.857,p = 0.016)。
调查时间可能解释了受过培训的受访者数量较少的原因。拥有理学学士药学学位的药剂师跟踪患者意愿增加可能反映了更长的执业时间和更紧密的社区联系。局限性包括普遍适用性低和样本量小。
密歇根州一小部分有代表性的药剂师样本对纳洛酮有一定了解,并对常备医嘱持支持态度。