Nguyen Andy M, Kearney Thomas E, Apollonio Dorie E
J Am Pharm Assoc (2003). 2020 Nov-Dec;60(6):1050-1057.e1. doi: 10.1016/j.japh.2020.08.032. Epub 2020 Sep 15.
In 2017, the Centers for Disease Control and Prevention reported more than 47,600 deaths as a result of opioid overdose in the United States. In an effort to reduce these deaths, California passed legislation providing pharmacists with the ability to furnish naloxone without a prescription. Our study examined pharmacies in San Francisco that furnished naloxone and provided guidance for pharmacies seeking to develop similar programs. The study aims were to (1) identify the legal, structural, social-environmental, and financial components of a pharmacy model that allows for successful naloxone distribution, (2) evaluate the attitudes and beliefs of pharmacy staff members toward patients receiving or requesting naloxone, and (3) assess relationships between these attitudes and beliefs and naloxone furnishing at the pharmacy.
This cross-sectional study used a series of semistructured interviews of pharmacy staff in San Francisco conducted April-October 2019. Through a thematic, inductive analysis of collected data, emerging themes were mapped to the primary study aims.
We interviewed 14 pharmacists and pharmacy technicians at 4 community pharmacies. We identified 4 factors for success in implementing a naloxone furnishing protocol: administrative-led efforts, pharmacist-led efforts, increasing pharmacist engagement, and increasing patient engagement. The respondents also discussed the approaches they used to overcome previously identified barriers: cost, time, expectations of unwanted clientele, and patients' feelings of stigma.
Pharmacists' approaches to implementing naloxone furnishing had common features across locations, suggesting many of these strategies could be replicated in other community pharmacies.
2017年，美国疾病控制与预防中心报告称，阿片类药物过量导致超过47,600人死亡。为减少此类死亡人数，加利福尼亚州通过立法，赋予药剂师无需处方即可提供纳洛酮的权力。我们的研究调查了旧金山提供纳洛酮的药房，并为寻求开展类似项目的药房提供指导。研究目的包括：（1）确定能成功分发纳洛酮的药房模式中的法律、结构、社会环境和财务要素；（2）评估药房工作人员对接受或索要纳洛酮的患者的态度和看法；（3）评估这些态度和看法与药房纳洛酮供应之间的关系。
这项横断面研究采用了2019年4月至10月对旧金山药房工作人员进行的一系列半结构化访谈。通过对收集到的数据进行主题归纳分析，将新出现的主题与主要研究目标进行映射。
我们采访了4家社区药房的14名药剂师和药房技术员。我们确定了成功实施纳洛酮供应方案的4个因素：行政主导的努力、药剂师主导的努力、提高药剂师的参与度以及提高患者的参与度。受访者还讨论了他们用来克服先前确定的障碍的方法：成本、时间、对不受欢迎顾客的预期以及患者的耻辱感。
药剂师实施纳洛酮供应的方法在不同地点有共同特点，这表明其中许多策略可在其他社区药房复制。
