Cloutier Renee M, Dowd William N, Aldridge Arnie, Walsh Caitlin A, Messman Brett A, Northcott Jessica L, Talbert Abigail, Manolis Chronis, Campbell Vanessa, Pringle Janice L
Program Evaluation and Research Unit, University of Pittsburgh School of Pharmacy, Pittsburgh, PA, USA.
RTI International, Research Triangle Park, NC, USA.
Public Health Rep. 2024 Sep 28:333549241277416. doi: 10.1177/00333549241277416.
US community pharmacies are a unique and underused health service setting for identifying and potentially intervening with patients at risk of opioid overdose or opioid use disorder with evidence-based practices such as screening, brief intervention, and referral to treatment (SBIRT). The aim of our study was to assess the feasibility of implementing SBIRT in community pharmacies in an urban county in terms of engagement, reach, and equity across the cascade of pharmacy screening and care.
Patients aged 18 years or older receiving a schedule II or III opioid prescription at 1 of 17 participating community pharmacies in Allegheny County, Pennsylvania, were invited to engage in SBIRT as part of Project Lifeline-II from June 2020 through January 2023. Participants completed a prescreen and/or a full screen. We calculated the percentage of patients who participated across the cascade of pharmacy screening and care, overall and by sex (male and female) and race (Black and White).
During the study period, 1952 unique adults (79.6%) were screened at least once (52.1% female; 58.0% White, 30.7% Black). Patients who identified as male (vs female) and Black (vs White) were more likely to have a positive prescreen (14.7% male vs 9.8% female; 16.4% Black vs 9.5% White), receive and complete a full screen (82.7% male vs 80.0% female; 83.6% Black vs 78.4% White), and score positively on the full screen (26.6% male vs 20.4% female; 26.8% Black vs 21.9% White).
Although additional research is needed to characterize the full effect of Project Lifeline-II on patient outcomes, our findings help reinforce the benefits of multipronged public health initiatives that include community pharmacists to address the substance use disorder crisis in the United States.
美国社区药房是一种独特且未得到充分利用的医疗服务场所，可通过筛查、简短干预及转介治疗（SBIRT）等循证实践，识别有阿片类药物过量风险或阿片类药物使用障碍的患者，并对其进行潜在干预。我们研究的目的是从参与药房筛查和护理的各个环节的参与度、覆盖范围和公平性方面，评估在一个城市县的社区药房实施SBIRT的可行性。
2020年6月至2023年1月期间，宾夕法尼亚州阿勒格尼县17家参与项目的社区药房中，为年龄在18岁及以上且正在接受II类或III类阿片类药物处方的患者，邀请他们参与“生命线- II项目”中的SBIRT。参与者完成预筛查和/或全面筛查。我们计算了参与药房筛查和护理各个环节的患者百分比，包括总体情况以及按性别（男性和女性）和种族（黑人和白人）划分的情况。
在研究期间，1952名成年人（79.6%）至少接受了一次筛查（女性占52.1%；白人占58.0%，黑人占30.7%）。男性（与女性相比）和黑人（与白人相比）身份的患者更有可能预筛查呈阳性（男性为14.7%，女性为9.8%；黑人16.4%，白人9.5%），接受并完成全面筛查（男性为82.7%，女性为80.0%；黑人83.6%，白人78.4%），并且在全面筛查中得分呈阳性（男性为26.6%，女性为20.4%；黑人26.8%，白人21.9%）。
尽管需要更多研究来描述“生命线- II项目”对患者结局的全面影响，但我们的研究结果有助于强化多管齐下的公共卫生举措的益处，这些举措包括社区药剂师，以应对美国的物质使用障碍危机。
