多组分教育干预对基于社区药房的纳洛酮服务实施的影响：一项实用随机对照试验。
Impact of a Multicomponent Educational Intervention on Community Pharmacy-Based Naloxone Services Implementation: A Pragmatic Randomized Controlled Trial.
机构信息
Department of Pharmacy Practice, Auburn University Harrison College of Pharmacy, Auburn, AL, USA.
Department of Health Outcomes Research and Policy, Auburn University Harrison College of Pharmacy, Auburn, AL, USA.
出版信息
Ann Pharmacother. 2023 Jun;57(6):677-695. doi: 10.1177/10600280221120405. Epub 2022 Sep 1.
BACKGROUND
Despite US naloxone access laws, community pharmacists lack training and confidence in providing naloxone.
OBJECTIVE
To assess the impact of the Empowering Community Pharmacists program on pharmacists' knowledge, perceived barriers, attitudes, confidence, and intentions regarding naloxone services implementation, as well as naloxone prescriptions dispensed.
METHODS
A 3-month pragmatic randomized controlled trial was conducted from December 2018 to March 2019. Alabama community pharmacists were recruited by mail, email, phone, and fax and randomized to intervention (monthly resources/reminders + educational webinar) or control (monthly reminders only). Outcome measures were assessed via online surveys at baseline (T1), immediately post-intervention (T2), and 3 months post-intervention (T3), including naloxone knowledge (%correct); perceived barriers, attitudes, confidence, and intention regarding naloxone services implementation (7-point Likert-type scale; 1 = strongly disagree, 7 = strongly agree); and number of naloxone prescriptions dispensed. Mean differences between control and intervention from T1 to T3 were assessed using 2-way mixed analysis of variance and adjusted analyses were conducted using generalized estimating equations with negative binomial distribution to assess associations between variables.
RESULTS
Of 55 participants (n = 27 intervention, n = 28 control), most were female (80.3%), white (80.6%), in independently owned pharmacies (39.1%). Increases in mean [SD] confidence (5.52 [1.03]-6.16 [0.74], < 0.0005) and intention (5.35 [1.51]-6.10 [0.96], = 0.023) occurred from pre- to post-program within the intervention group and were statistically significant compared with control (confidence = 0.016, intention = 0.014). Confidence (exp(β) = 1.46, = 0.031) and perceived barriers (exp(β) = 0.75, = 0.022) were associated with number of naloxone prescriptions dispensed.
CONCLUSION AND RELEVANCE
The Empowering Community Pharmacists program improved community pharmacists' confidence and intention regarding naloxone services implementation. Other states can adapt program elements according to their laws.
CLINICALTRIALS.GOV IDENTIFIER: NCT05093309.
背景
尽管美国有纳洛酮获取法，但社区药剂师在提供纳洛酮方面缺乏培训和信心。
目的
评估“授权社区药剂师计划”对药剂师在实施纳洛酮服务方面的知识、感知障碍、态度、信心和意愿，以及开出的纳洛酮处方数量的影响。
方法
这是一项为期 3 个月的实用随机对照试验，于 2018 年 12 月至 2019 年 3 月进行。阿拉巴马州的社区药剂师通过邮件、电子邮件、电话和传真招募，并随机分为干预组（每月资源/提醒+教育网络研讨会）或对照组（仅每月提醒）。使用在线调查在基线（T1）、干预后即刻（T2）和干预后 3 个月（T3）评估结果测量，包括纳洛酮知识（正确百分比）；对实施纳洛酮服务的感知障碍、态度、信心和意愿（7 点李克特量表；1=强烈不同意，7=强烈同意）；以及开出的纳洛酮处方数量。使用 2 路混合方差分析评估 T1 至 T3 期间控制组和干预组之间的平均差异，并使用具有负二项式分布的广义估计方程进行调整分析，以评估变量之间的关联。
结果
在 55 名参与者中（n=27 名干预组，n=28 名对照组），大多数是女性（80.3%）、白人（80.6%），在独立拥有的药店工作（39.1%）。干预组内从预干预到后干预，信心（5.52[1.03]-6.16[0.74]，<0.0005）和意愿（5.35[1.51]-6.10[0.96]，=0.023）的平均值均有所增加，与对照组相比具有统计学意义（信心=0.016，意愿=0.014）。信心（exp（β）=1.46，=0.031）和感知障碍（exp（β）=0.75，=0.022）与开出的纳洛酮处方数量有关。
结论和相关性
“授权社区药剂师计划”提高了社区药剂师在实施纳洛酮服务方面的信心和意愿。其他州可以根据自己的法律调整计划内容。
临床试验.gov 标识符：NCT05093309。
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