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评估药剂师准备分发纳洛酮和就应对阿片类药物过量提供咨询的能力。

Assessing pharmacists' readiness to dispense naloxone and counsel on responding to opioid overdoses.

出版信息

J Am Pharm Assoc (2003). 2019 Jul-Aug;59(4):550-554.e2. doi: 10.1016/j.japh.2019.04.012. Epub 2019 May 17.

Abstract

OBJECTIVES

The United States declared the opioid crisis a Public Health Emergency in 2017 and recommended increasing access and availability of naloxone, a reversal agent for opioid overdose. In Massachusetts, there is a statewide standing order for naloxone, which allows pharmacists to dispense it without a prescription to any person at-risk of experiencing an opioid overdose or other persons who can assist individuals at-risk. The objective of this study was to determine whether pharmacists in Massachusetts have sufficient education and training to fulfill the duties associated with dispensing naloxone in community pharmacy settings. The researchers investigated the pharmacists' ability to counsel patients both on naloxone and management of patients with an opioid overdose.

METHODS

At the time of the study, pharmacies could elect to have a standing order for naloxone. A randomized sample of 100 pharmacies was generated from the 792 pharmacies with a standing order. From this sample, 79 of the 100 pharmacies were visited on the basis of convenience and distribution in eastern and central Massachusetts. At each pharmacy, a validated 25-item survey was administered to pharmacists.

RESULTS

Fewer than half of participants knew that different formulations of naloxone possess different quantities. Although 52% of pharmacists indicated the need to call 9-1-1 when witnessing an opioid overdose, 8% knew to start rescue breathing, and 4% knew to place patients in the recovery position.

CONCLUSION

Despite regulations requiring all pharmacies with a standing order to provide training on naloxone, many of the pharmacists surveyed did not have a strong understanding about naloxone products or its pharmacology. The level of education Massachusetts pharmacists possess on naloxone products and administration is not sufficient to counsel patients regarding this medication. Increasing training requirements in pharmacy schools and continuing education offers potential solutions to the lack of knowledge in the community pharmacy setting.

摘要

目的

美国于 2017 年宣布阿片类药物危机为公共卫生紧急事件,并建议增加纳洛酮(一种阿片类药物过量的解毒剂)的获取和可及性。在马萨诸塞州,全州范围内对纳洛酮实行了一项常备令,允许药剂师在没有处方的情况下向任何有阿片类药物过量风险的人或可以帮助有风险的人的人分发纳洛酮。本研究的目的是确定马萨诸塞州的药剂师是否具备充分的教育和培训,以履行在社区药房环境中分发纳洛酮的职责。研究人员调查了药剂师在纳洛酮和阿片类药物过量患者管理方面为患者提供咨询的能力。

方法

在研究时,药房可以选择有纳洛酮常备令。从 792 家有常备令的药房中随机抽取 100 家药房。在此样本中,根据便利原则和在马萨诸塞州东部和中部的分布情况,对其中的 79 家药房进行了访问。在每家药房,对药剂师进行了一项经过验证的 25 项调查。

结果

不到一半的参与者知道不同配方的纳洛酮具有不同的含量。尽管 52%的药剂师表示在目睹阿片类药物过量时需要拨打 9-1-1,但 8%的人知道要开始进行人工呼吸,4%的人知道要将患者置于恢复体位。

结论

尽管有规定要求所有有常备令的药房都要提供纳洛酮培训,但接受调查的许多药剂师对纳洛酮产品或其药理学并没有深入的了解。马萨诸塞州药剂师对纳洛酮产品和管理的教育水平不足以就该药物为患者提供咨询。增加药学院和继续教育的培训要求可能是解决社区药房知识不足的潜在方法。

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