Welsh Justine W, Yarbrough Courtney R, Sitar Siara I, Mataczynski Maggie J, Peralta Andrea M, Kan Mary, Crawford Natalie D, Conrad Tahbia A, Kee Caroline, Young Henry N
J Am Pharm Assoc (2003). 2023 May-Jun;63(3):751-759. doi: 10.1016/j.japh.2022.12.015. Epub 2022 Dec 16.
Research has focused on buprenorphine prescribing with limited attention to the role of pharmacy access to buprenorphine for opioid use disorder.
This study examines demographic and socioeconomic correlates to buprenorphine access in Georgia pharmacies.
A 5-question (12 potential subqueries) telephone administered survey was used to investigate access and stocking patterns of specific dosages and formulations of buprenorphine in Georgia pharmacies (n = 119). Descriptive statistics characterized physician and pharmacy demographics and buprenorphine stocking practices. Correlations between various factors including buprenorphine stocking practices, geographic, and sociodemographic characteristics were identified using nonlinear regression models.
The majority of pharmacies stocked the most commonly prescribed 8/2 mg dosage strength of buprenorphine/naloxone films and tablets (69.0% and 63.0%, respectively). Other strengths were less likely to be readily available. Pharmacies in Suburban Census tracts were 77.0% more likely to stock any type of buprenorphine monotherapy [odds ratio (OR) = 1.77, t = 2.37, P < 0.05] and 58.1% more likely to stock the 8 mg buprenorphine monotherapy formulation [OR = 1.58, t = 2.15, P < 0.05] than Urban tracts. Pharmacies in areas with above-average non-White populations were 29.6% more likely to stock a monotherapy product [OR = 1.30, t = 2.16, P < 0.05], and those in areas with above-average poverty rates were more likely to stock the 8 mg/2 mg buprenorphine/naloxone tablets [OR = 1.04, t = 2.02, P < 0.05]. There were no additional differences across the sample in formulation or dosage strengths. Pharmacists who endorsed challenges dispensing buprenorphine (23.3%) cited issues around insurance coverage, payment difficulty, prior authorization issues, and low stock of specific formulations.
Results suggest that low availability of certain dosages or formulations of buprenorphine in local pharmacies could obstruct access for patients. Future research should address barriers to supplying buprenorphine and collaborative measures between pharmacists and prescribers to improve access.
研究主要集中在丁丙诺啡的处方开具上，而对药房获取丁丙诺啡用于阿片类物质使用障碍治疗的作用关注有限。
本研究调查佐治亚州药房中丁丙诺啡获取情况与人口统计学和社会经济因素的相关性。
采用一项包含5个问题（12个潜在子问题）的电话调查，以研究佐治亚州药房（n = 119）中丁丙诺啡特定剂量和剂型的获取及库存模式。描述性统计分析了医生和药房的人口统计学特征以及丁丙诺啡的库存情况。使用非线性回归模型确定了包括丁丙诺啡库存情况、地理和社会人口统计学特征等各种因素之间的相关性。
大多数药房备有最常用处方剂量的丁丙诺啡/纳洛酮薄膜片和片剂，即8/2毫克剂型（分别为69.0%和63.0%）。其他剂量剂型不太容易随时获得。郊区人口普查区的药房储备任何类型丁丙诺啡单一疗法药物的可能性比城市地区高77.0%[比值比（OR）= 1.77，t = 2.37，P < 0.05]，储备8毫克丁丙诺啡单一疗法剂型的可能性比城市地区高58.1%[OR = 1.58，t = 2.15，P < 0.05]。非白人人口高于平均水平地区的药房储备单一疗法产品的可能性高29.6%[OR = 1.30，t = 2.16，P < 0.05]，贫困率高于平均水平地区的药房储备8毫克/2毫克丁丙诺啡/纳洛酮片剂的可能性更高[OR = 1.04，t = 2.02，P < 0.05]。样本中在剂型或剂量强度方面没有其他差异。认可在丁丙诺啡配药方面存在挑战的药剂师（23.3%）提到了保险覆盖、支付困难、预先授权问题以及特定剂型库存不足等问题。
结果表明，当地药房中某些丁丙诺啡剂量或剂型供应不足可能会阻碍患者获取药物。未来的研究应解决丁丙诺啡供应方面的障碍以及药剂师与开处方者之间的合作措施，以改善药物获取情况。
