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全州范围内社区药房减少阿片类药物危害方法的影响

Impact of a statewide community pharmacy approach to opioid harm reduction.

作者信息

Sexton Scott M, Marciniak Macary Weck, Gatton Ouita, Shelton Penny

出版信息

J Am Pharm Assoc (2003). 2023 Jan-Feb;63(1):389-395.e1. doi: 10.1016/j.japh.2022.10.020. Epub 2022 Oct 22.

Abstract

BACKGROUND

The past several years have seen sharp increases in opioid overdose mortality. Harm reduction resources, such as nonprescription syringes and naloxone, are used to save lives.

OBJECTIVES

To develop a statewide approach to increase the use of opioid harm reduction services through community pharmacies.

PRACTICE DESCRIPTION

The North Carolina Association of Pharmacists was awarded a grant to address opioid mortality across the state, using community pharmacies to address opioid use disorder.

PRACTICE INNOVATION

A statewide, standardized approach was implemented to increase knowledge and use of opioid harm reduction resources in the community pharmacy setting.

EVALUATION METHODS

Pharmacies were offered training related to harm reduction. Participating pharmacies provided monthly updates related to staff training, syringe access status, naloxone kits distributed, and comments about how the training was changing their practice. At the project conclusion, pharmacies provided retrospective naloxone dispensing data along with naloxone dispensing during the intervention period. Pharmacies shared the greatest benefit of the program, a potential change to make implementation simpler, and the biggest change in the pharmacist(s) as a result of the project. Descriptive statistics were used to analyze data.

RESULTS

A total of 58 pharmacies across 33 counties participated in the harm reduction project. Of the 100 North Carolina counties, 15 counties were identified as high-need, and 14 of the 15 high-need counties (93%) participated in this project. Of the 58 participating pharmacies, 40 pharmacies (69%) had or implemented a nondiscriminatory nonprescription syringe policy within their pharmacy. During the baseline period (January 1, 2018, to June 15, 2018), 177 prescriptions for naloxone were dispensed by participating pharmacies. During the intervention period (January 1, 2019, to June 15, 2019), 639 prescriptions for naloxone were dispensed, representing a 361% increase in naloxone dispensing.

CONCLUSION

The successful implementation of a standardized, statewide approach increased access to harm reduction services.

摘要

背景

在过去几年中,阿片类药物过量致死率急剧上升。减少伤害资源,如非处方注射器和纳洛酮,被用于挽救生命。

目的

制定一项全州范围的方法,以增加社区药房对阿片类药物减少伤害服务的使用。

实践描述

北卡罗来纳州药剂师协会获得一笔拨款,用于解决全州范围内的阿片类药物致死问题,利用社区药房应对阿片类药物使用障碍。

实践创新

实施了一种全州范围的标准化方法,以增加社区药房环境中阿片类药物减少伤害资源的知识和使用。

评估方法

为药房提供与减少伤害相关的培训。参与的药房每月提供有关员工培训、注射器获取状况、分发的纳洛酮试剂盒以及关于培训如何改变其做法的评论的最新信息。在项目结束时,药房提供回顾性纳洛酮配药数据以及干预期间的纳洛酮配药情况。药房分享了该项目的最大益处、使实施更简单的潜在变化以及项目导致的药剂师的最大变化。使用描述性统计分析数据。

结果

33个县的58家药房参与了减少伤害项目。在北卡罗来纳州的100个县中,15个县被确定为高需求县,15个高需求县中的14个(93%)参与了该项目。在58家参与的药房中,40家药房(69%)在其药房内拥有或实施了非歧视性非处方注射器政策。在基线期(2018年1月1日至2018年6月15日),参与的药房分发了177份纳洛酮处方。在干预期(2019年1月1日至2019年6月15日),分发了639份纳洛酮处方,纳洛酮配药增加了361%。

结论

成功实施标准化的全州范围方法增加了减少伤害服务的可及性。

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