Department of Emergency Medicine, Injury Prevention Center, Boston Medical Center/Boston University School of Medicine, Boston, Massachusetts, USA.
Department of Emergency Medicine, Injury Prevention Center, Rhode Island Hospital, Providence, Rhode Island, USA.
Subst Abus. 2022;43(1):64-68. doi: 10.1080/08897077.2020.1736236. Epub 2020 Mar 18.
Opioid overdose is a preventable injury leading to high morbidity and premature mortality in communities across the United States. Overdoses take place where people use drugs, including commercial and public locations like community pharmacies, and necessitate swift detection and response to avoid harm and, even more seriously, death. The presence of emergency and safety protocols improves occupational health and safety for all in the workplace. The aim of this study was to assess the prevalence of experience with on-site pharmacy overdose and to explore pharmacist and site characteristics associated with having a known protocol for responding to on-site overdose emergencies.
: An anonymous, online survey about naloxone provision and opioid safety was delivered by email, through professional pharmacy associations and continuing education attendance lists, to 3,100 pharmacists in Massachusetts and Rhode Island between October 2017 and January 2018. Survey items gauged socio-demographics, practice site characteristics, safer opioid dispensing and naloxone provision. Summary statistics and bivariate analyses were conducted to describe characteristics associated with items pertaining to on-site overdose policy awareness.
: Of the 357 respondents (11.5% response rate), 154 (5.0%) answered the questions of interest: 17.5% reported having at least one suspected overdose on-site at their practice location, while 42.9% reported that they were knowledgeable about and could locate at their practice location an on-site overdose protocol detailing how to respond to an overdose. Pharmacists who were knowledgeable about protocols were also more likely to offer naloxone to patients ( = 0.02) and did not practice at a chain pharmacy ( = 0.01).
: Community pharmacies that stock and distribute naloxone are key parts of community efforts to address the opioid crisis. Pharmacies and other healthcare settings should develop and implement on-site overdose response protocols and cultivate a norm of naloxone provision to patients.
在美国各地的社区，阿片类药物过量是一种可预防的伤害，导致高发病率和过早死亡率。药物滥用者会发生过量用药，包括在社区药店等商业和公共场所，因此需要迅速发现和应对，以避免伤害，更严重的是，避免死亡。紧急和安全协议的存在可以提高工作场所所有人员的职业健康和安全。本研究旨在评估现场药房过量用药的经验发生率，并探讨与现场过量用药紧急情况应对相关的药剂师和场所特征。
2017 年 10 月至 2018 年 1 月期间，通过电子邮件、专业药房协会和继续教育出勤率名单，向马萨诸塞州和罗得岛州的 3100 名药剂师发送了一份关于纳洛酮供应和阿片类药物安全的匿名在线调查。调查项目衡量了社会人口统计学、实践场所特征、更安全的阿片类药物配药和纳洛酮供应情况。进行了汇总统计和双变量分析，以描述与现场过量用药政策意识相关的特征。
在 357 名受访者中（回应率为 11.5%），有 154 名（5.0%）回答了感兴趣的问题：17.5%的人报告在其执业地点至少有一次疑似现场过量用药，而 42.9%的人报告他们了解并能够在执业地点找到现场过量用药协议，详细说明如何应对过量用药。了解协议的药剂师更有可能向患者提供纳洛酮（=0.02），并且不在连锁药店执业（=0.01）。
储存和分发纳洛酮的社区药房是解决阿片类药物危机的社区努力的关键部分。药房和其他医疗保健场所应制定和实施现场过量用药应对协议，并培养向患者提供纳洛酮的规范。
