Association Between a State Law Allowing Pharmacists to Dispense Naloxone Without a Prescription and Naloxone Dispensing Rates

Gangal, N.; Hincapie, Ana L.; Jandarov, Roman; Frede, Stacey M.; Boone, Jill; MacKinnon, Neil J.; Koechlin, Kathleen; DeFiore-Hyrmer, Jolene; Holthusen, Amy; Heaton, Pamela C.

doi:10.1001/jamanetworkopen.2019.20310

Cited by 21 publications

(15 citation statements)

References 20 publications

(38 reference statements)

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“…Some programs used laws to enhance naloxone access, such as expanding the pharmacist’s naloxone prescriptive authority [ 19 , 21 , 24 ], making naloxone an over-the-counter medication [ 30 ], or mandating that naloxone be co-prescribed with an opioid prescription [ 27 ]. For the latter study, the program was implemented across several US states and mandated naloxone as a co-prescription to patients with specific criteria [ 27 ].…”

Section: Resultsmentioning

confidence: 99%

“…While a wide variety of THN programs were described, none measured patient outcomes and few measured program efficacy [18,[29][30][31]. Of the programs that were evaluated, they all showed a positive impact on naloxone dispensing [19][20][21][22][23][24][25][26][27][28]. This review involved research in Canada, the US, Australia, and Scotland.…”

Section: Discussionmentioning

confidence: 99%

“…Most studies were published between 2019 and 2020. Ten out of 18 studies (55%) measured the impact of the THN program on naloxone dispensing; all noted that naloxone dispensing increased after THN program implementation [19][20][21][22][23][24][25][26][27][28]. Patient outcomes were not commonly studied; however, some studies (4/18, 22%) discussed the efficacy of the THN program through opioid overdose reversal rates or the number of naloxone kit refills [18,[29][30][31].…”

Section: Take-home Naloxone Programs and Program Interventionsmentioning

confidence: 99%

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What Is Known about Community Pharmacy-Based Take-Home Naloxone Programs and Program Interventions? A Scoping Review

2021

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A variety of new sources describing community pharmacy-based take-home naloxone (THN) programs have emerged recently in the literature. There is a need to define the types of take-home naloxone programs being offered to support future research designs in implementing and evaluating standardized programs that fill pharmacist and patient knowledge gaps and lift current barriers for optimal community pharmacy naloxone provision. The objective of this paper is to summarize the literature on community pharmacy-based THN programs, including specific program interventions used to increase naloxone dispensing, naloxone availability and dispensing patterns, facilitators and barriers for the THN programs, and knowledge gaps. Online databases such as PubMed, EMBASE, Scopus, and International Pharmaceutical Abstracts (IPA) and a search of the grey literature were used to identify eligible sources. Sources were screened by two reviewers for eligibility in COVIDENCE software. Both reviewers compared screening results and resolved conflicts through discussion. A data extraction form for all identified full texts was completed by both reviewers and results were compiled through reviewer discussion. Fifty-two sources met the eligibility criteria. The top three barriers identified were: cost/coverage of naloxone, stigma, and education/training for pharmacists. THN program interventions included screening tools, checklists, pocket cards, patient brochures, and utilizing the pharmacy management system to flag eligible patients. Patient knowledge gaps included naloxone misinformation and lack of awareness, while pharmacists demonstrated administrative, clinical, and counselling knowledge gaps. Naloxone availability was found to be highly variable, where independent and rural pharmacies were less likely to stock or dispense naloxone. Further, pharmacies located in districts with higher rates of opioid overdose deaths and lower household income were also less likely to have naloxone available. This review identified multiple new programs, showcasing that the implementation and evaluation of THN programs are an expanding area of research. Future research should focus on implementing and evaluating a THN program through a randomized controlled trial design that incorporates solutions for the barriers and knowledge gaps identified in this study.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Take-home Naloxone Programs and Program Interventionsmentioning

confidence: 99%

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What Is Known about Community Pharmacy-Based Take-Home Naloxone Programs and Program Interventions? A Scoping Review

2021

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“…In a separate, interrupted time series analysis, the effectiveness of an Ohio law allowing pharmacists to dispense naloxone without a prescription was evaluated. After implementation of this law in July 2015, the amount of naloxone dispensed increased by 2328%, thus greatly enhancing access to this drug [ 13 ].…”

Section: Overview Of the Opioid Crisis In The United States And Inmentioning

confidence: 99%

Addressing the Opioid Crisis through an Interdisciplinary Task Force in Cincinnati, Ohio, USA

MacKinnon

Privitera

2020

Pharmacy

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Opioid use has been a topic of concern in recent years in the United States, causing thousands of deaths each year. Ohio is one of the states hit hardest by the epidemic, and its state and local governments have responded with comprehensive health policies. Cincinnati, located in the southwest region of Ohio, is one of the epicenters of the state’s opioid crisis. Responding to the needs of their community, the University of Cincinnati (UC) and its affiliate health system, UC Health, have brought together leaders in research, clinical practice, and education to form the UC/UC Health Opioid Task Force. By encouraging interdisciplinary partnerships, the Task Force is pioneering new ways to understand, prevent, and treat opioid use disorder, while preparing the next generation of healthcare professionals. Additionally, collaboration across departments in UC Health has improved access to treatment and recovery resources for hundreds of patients. Leading educational events, supporting local agencies, and participating in government initiatives have further solidified UC and UC Health’s role as a stakeholder in this crisis, showcasing how academic health centers are critical to promoting public health.

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“…In another example, allowing pharmacists to dispense naloxone, an opioid-reversal agent, without a prescription in many states has increased access to a potentially life-saving medication. In Ohio, the implementation of this law was associated with a significant increase (2328%) in naloxone dispensing rates [ 18 ]. Similarly, within the current pharmacist scope of practice, there are increasing opportunities for pharmacists to improve preconception care [ 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 ].…”

Section: Introductionmentioning

confidence: 99%

Patient Screenings for Preconception Health Interventions at a Community Pharmacy

et al. 2020

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Preconception health refers to health before pregnancy and involves addressing risk factors that can negatively impact either a patient or future pregnancy. Pharmacists can play an essential role in screening for and managing patients’ risk factors to optimize pregnancy outcomes. The primary objective of this study is to determine whether preconception health screenings in community pharmacy settings identify opportunities for preconception health services, particularly pharmacy-based interventions. The secondary objectives are to describe the preconception health status of community pharmacy patients and their interest in receiving preconception care services by a clinical pharmacist in a community pharmacy setting. Two independent pharmacies conducted a pilot project where people were invited to complete a health screening form that evaluated their preconception health. Participants received a personalized health report with an invitation to meet with the clinical pharmacist for services related to identified opportunities, such as contraception and immunizations. Retrospective analysis was conducted for data collected from 43 women during the patient screening effort in three community pharmacy settings (two independent community pharmacy locations and one neighborhood pharmacy outreach event). Nearly all participants (n = 42, 98%) had at least one opportunity identified to receive preconception care services, with the majority related to their alcohol use (60%). A majority of participants (56%) indicated an interest in learning more about preconception services offered at the pharmacy, but only 19% wanted to schedule an appointment with a pharmacist. Thus, there is an apparent need and opportunity for utilization of preconception health services at the pharmacy.

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Association Between a State Law Allowing Pharmacists to Dispense Naloxone Without a Prescription and Naloxone Dispensing Rates

Cited by 21 publications

References 20 publications

What Is Known about Community Pharmacy-Based Take-Home Naloxone Programs and Program Interventions? A Scoping Review

What Is Known about Community Pharmacy-Based Take-Home Naloxone Programs and Program Interventions? A Scoping Review

Addressing the Opioid Crisis through an Interdisciplinary Task Force in Cincinnati, Ohio, USA

Patient Screenings for Preconception Health Interventions at a Community Pharmacy

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