J Am Pharm Assoc (2003). 2023 Mar-Apr;63(2):566-573. doi: 10.1016/j.japh.2022.10.028. Epub 2022 Nov 2.
California has sought to expand medication access and improve public health by authorizing pharmacists in California to prescribe certain medications since 2014. Medications with pharmacist-initiated prescribing, or furnishing, include naloxone, hormonal contraception, postexposure prophylaxis/preexposure prophylaxis, and nicotine replacement therapy. In light of the United States' opioid epidemic, naloxone, an opioid antagonist, this study considered furnishing rates in urban areas of California. Research from 2020 found 42.5% of pharmacies furnished naloxone. However, there has been limited study of furnishing outside of urban areas.
This study assessed pharmacist furnishing rates of naloxone in California's Central Valley and identified barriers and facilitators to implementation.
From April to May 2022, the researchers first conducted a cross-sectional, observational study of community and mail-order pharmacies in California's largely rural Central Valley, then collected interview data from a subset of pharmacists in stores that indicated they furnished naloxone.
Forty-three percent of Central Valley pharmacies reported that they furnished naloxone. Interview respondents reported that barriers to furnishing included time restrictions, cost to patients, stigma, and language barriers.
Furnishing rates in the Central Valley were slightly higher (43.4%) than those reported in previous research focusing on urban areas of California (42.5%). Identified barriers to furnishing were consistent with those identified in previous research. These findings suggest that further policy interventions may be needed to reduce out-of-pocket costs, establish stronger pharmacist-provider relationships, and provide education combatting stigma against opioid users to increase naloxone furnishing.
自 2014 年以来，加州一直试图通过授权药剂师开具某些药物来扩大药物获取途径并改善公共卫生。具有药剂师发起的处方或提供服务的药物包括纳洛酮、激素避孕、暴露后预防/暴露前预防和尼古丁替代疗法。鉴于美国阿片类药物泛滥，纳洛酮是一种阿片类拮抗剂，本研究考虑了加州城市地区的提供率。2020 年的研究发现，42.5%的药店提供纳洛酮。然而，对于城市地区以外的提供情况的研究有限。
本研究评估了加州中央谷地区药剂师提供纳洛酮的比率，并确定了实施的障碍和促进因素。
2022 年 4 月至 5 月，研究人员首先对加州大部分农村地区的中央谷地区的社区和邮购药店进行了横断面观察性研究，然后从表示提供纳洛酮的药店中收集了一组药剂师的访谈数据。
43%的中央谷地区药店表示提供纳洛酮。受访者报告的提供障碍包括时间限制、患者费用、污名化和语言障碍。
中央谷地区的提供率（43.4%）略高于之前关注加州城市地区的研究报告的（42.5%）。确定的提供障碍与之前研究中确定的障碍一致。这些发现表明，可能需要进一步的政策干预来降低自付费用，建立更强的药剂师-提供者关系，并提供教育以消除对阿片类药物使用者的污名化，以增加纳洛酮的提供。
