College of Pharmacy, The University of Texas at Austin, Austin, TX, USA.
Department of Psychiatry and Behavioral Sciences, University of Texas Health San Antonio, Austin, TX, USA.
Addiction. 2021 Jun;116(6):1505-1511. doi: 10.1111/add.15314. Epub 2020 Nov 22.
Patients with opioid use disorder (OUD) must be able to obtain prescribed buprenorphine/naloxone films (BUP/NX) and naloxone nasal spray (NNS) from a pharmacy promptly to reduce risk for a recurrence of use and subsequent morbidity and mortality. Telephone audits have identified concerning gaps in availability of NNS within US pharmacies, but the availability of BUP/NX has not been rigorously evaluated. This study estimated the availability of BUP/NX and NNS in the US state of Texas and compared availability by pharmacy type and metropolitan status.
A cross-sectional telephone audit with a secret shopper approach conducted from 18 May 2020 to 7 June 2020. Setting and Participants A random sample of 800 of 5078 (16%) community pharmacies licensed with the Texas State Board of Pharmacy.
Primary outcomes included availability of a 1-week supply of generic BUP/NX 8/2 mg films and a single unit of NNS 4 mg, overall and by pharmacy type. Secondary outcomes included willingness and estimated time-frame to order BUP/NX if unavailable.
Data from 704 pharmacies (471 chain, 233 independent) were included for analyses. Of these, 34.1% of pharmacies (45.0% of chains versus 12.0% of independents, P < 0.0001) were willing and able to dispense a 1-week supply of generic BUP/NX and a single unit of NNS. BUP/NX alone was available in 42.2% of pharmacies (52.4% of chains versus 21.5% of independents, P < 0.0001). NNS alone was available in 60.1% of pharmacies (77.9% of chains versus 24.0% of independents, P < 0.0001). Of the 397 pharmacies with generic BUP/NX unavailable, 62.2% of pharmacies (73.9% of chains versus 48.0% of independents, P < 0.0001) indicated willingness to order.
Most pharmacies in Texas do not appear to be willing and able to dispense prescribed buprenorphine/naloxone films and naloxone nasal spray to patients with opioid use disorder in a timely manner. Deficiencies in availability are markedly more pronounced in independent pharmacies compared with chain pharmacies.
患有阿片类药物使用障碍（OUD）的患者必须能够从药房及时获得规定的丁丙诺啡/纳洛酮膜（BUP/NX）和纳洛酮鼻喷雾剂（NNS），以降低使用复发以及随后的发病率和死亡率的风险。电话审计发现，美国药房中 NNS 的供应存在令人担忧的差距，但 BUP/NX 的供应情况尚未经过严格评估。本研究估计了美国德克萨斯州 BUP/NX 和 NNS 的供应情况，并比较了按药房类型和大都市地位的供应情况。
2020 年 5 月 18 日至 2020 年 6 月 7 日进行的一项具有秘密购物者方法的横断面电话审计。
从德克萨斯州药剂师委员会获得许可的 5078 家社区药房中随机抽取 800 家。
主要结局包括提供一周剂量的通用 BUP/NX 8/2mg 薄膜和单一单位 NNS 4mg 的供应情况，总体情况和按药房类型情况。次要结局包括如果没有 BUP/NX，愿意并估计订购的时间框架。
对 704 家药房（471 家连锁，233 家独立）的数据进行了分析。其中，34.1%的药房（45.0%的连锁店与 12.0%的独立药房，P<0.0001）愿意且能够配给一周剂量的通用 BUP/NX 和单一单位的 NNS。有 42.2%的药房（52.4%的连锁店与 21.5%的独立药房，P<0.0001）可单独提供 BUP/NX。有 60.1%的药房（77.9%的连锁店与 24.0%的独立药房，P<0.0001）可单独提供 NNS。在 397 家没有通用 BUP/NX 的药房中，62.2%的药房（73.9%的连锁店与 48.0%的独立药房，P<0.0001）表示愿意订购。
德克萨斯州的大多数药房似乎不愿意并且无法及时向患有阿片类药物使用障碍的患者提供规定的丁丙诺啡/纳洛酮薄膜和纳洛酮鼻喷雾剂。与连锁店相比，独立药房在供应方面的明显缺陷更为明显。
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