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Pharmacy naloxone codispensing: A mixed methods study of practices and perspectives under a statewide standing order
Journal of the American Pharmacists Association : Japha
|April 22, 2022
Summary
Pharmacists in Massachusetts see barriers and facilitators to codispensing naloxone with opioid prescriptions. Interventions like technician training and addressing stigma can improve access to this life-saving overdose reversal medication.
Area of Science:
- Public Health
- Pharmacy Practice
- Opioid Overdose Prevention
Background:
- Previous trials showed high naloxone accessibility via standing orders in Massachusetts.
- Expanding naloxone access through pharmacy codispensing is crucial for reducing overdose deaths.
Purpose of the Study:
- To investigate pharmacists' perspectives on naloxone codispensing under the Massachusetts Naloxone Standing Order (NSO) program.
- To identify facilitators and barriers influencing naloxone codispensing practices in community pharmacies.
Main Methods:
- Mixed methods study involving 3 focus groups (N=27) and a quantitative survey (N=339) of Massachusetts pharmacists.
- Data collection occurred between September 2018 and November 2019.
- Analysis examined current policies, practices, and attitudes towards naloxone codispensing.
Main Results:
- 69% of pharmacists reported promoting naloxone codispensing, primarily for high-dose opioid or concurrent benzodiazepine prescriptions.
- Facilitators included prescriber relationships and mandatory consultations; barriers involved patient interaction concerns, training, and workflow.
- No significant differences were observed between chain and independent pharmacies.
Conclusions:
- Identified key facilitators and barriers to naloxone codispensing in Massachusetts pharmacies.
- Interventions should focus on enhanced technician training, mandatory pharmacist consultations, workflow improvements, and addressing stigma.
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