Department of Pharmacy Practice, Campbell University College of Pharmacy and Health Sciences, Buies Creek, North Carolina, USA.
Doctor of Medicine Program, Duke University School of Medicine, Durham, North Carolina, USA.
Subst Abus. 2019;40(4):476-483. doi: 10.1080/08897077.2019.1616349. Epub 2019 Aug 16.
Pharmacists are on the frontline caring for patients at risk of an opioid overdose and for patients with an opioid use disorder (OUD). Dispensing naloxone and medications for OUD and counseling patients about these medications are ways pharmacists can provide care. Key to pharmacists' involvement is their willingness to take on these practice responsibilities. The purpose of this scoping review is to identify, evaluate, and summarize published literature describing pharmacists' attitudes toward naloxone and medications for OUD, i.e., methadone, buprenorphine, and naltrexone. All searches were performed on December 7, 2018, in 5 databases: Embase.com, PubMed.gov, Cumulative Index to Nursing and Allied Health Literature (CINAHL) via EBSCOhost, Cochrane Central Register of Controlled Trials via Wiley, and Clarivate Web of Science. Articles included original research conducted in the United States, described attitude-related language toward naloxone and medications for OUD, and pharmacists. A total of 1323 articles were retrieved, 7 were included. Five studies reported on pharmacists' attitudes toward naloxone dispensing, 1 study reported on attitudes toward naloxone, buprenorphine, and buprenorphine/naloxone, and 1 reported on attitudes toward buprenorphine/naloxone. Respondents were diverse, including pharmacists from different practice specialties. Studies found that pharmacists agreed with a naloxone standing order, believed that naloxone should be dispensed to individuals at risk of an opioid overdose, and were supportive of dispensing buprenorphine. A minority of pharmacists expressed negative attitudes. Barriers cited to implementation included education and training, workflow, and management support. Pharmacists were positive in their attitudes toward increased practice responsibilities for patients at risk of an opioid overdose or with an OUD. Pharmacists must receive education and training to be current in their understanding of OUD medications, and they must be supported in order to provide effective care to this patient population.
药剂师站在前线，照顾有阿片类药物过量风险的患者和患有阿片类药物使用障碍（OUD）的患者。分发纳洛酮和 OUD 药物，并就这些药物为患者提供咨询是药剂师提供护理的方式。药剂师参与的关键是他们愿意承担这些实践责任。本范围综述的目的是确定、评估和总结已发表的文献，描述药剂师对纳洛酮和 OUD 药物（即美沙酮、丁丙诺啡和纳曲酮）的态度。所有搜索均于 2018 年 12 月 7 日在 5 个数据库中进行：Embase.com、PubMed.gov、通过 EBSCOhost 的 Cumulative Index to Nursing and Allied Health Literature (CINAHL)、通过 Wiley 的 Cochrane Central Register of Controlled Trials 以及 Clarivate Web of Science。文章包括在美国进行的原始研究，描述了与 OUD 相关的纳洛酮和药物的态度以及药剂师。共检索到 1323 篇文章，其中 7 篇被纳入。五项研究报告了药剂师对纳洛酮配药的态度，一项研究报告了对纳洛酮、丁丙诺啡和丁丙诺啡/纳曲酮的态度，一项报告了对丁丙诺啡/纳曲酮的态度。受访者各不相同，包括来自不同实践专业的药剂师。研究发现，药剂师同意纳洛酮的常备医嘱，认为应该向有阿片类药物过量风险的个人发放纳洛酮，并支持配给丁丙诺啡。少数药剂师持负面态度。实施的障碍包括教育和培训、工作流程和管理支持。药剂师对增加对有阿片类药物过量风险或患有 OUD 的患者的实践责任持积极态度。药剂师必须接受教育和培训，以了解最新的 OUD 药物知识，并且必须得到支持，才能为这一患者群体提供有效护理。
