Educational programs implemented for pharmacists after state passage of a standing order for naloxone: A systematic review of current practices

Freibott, Christina E.; Walker, A. S.; Maio, Vittorio; Frasso, Rosemary

doi:10.1016/j.japh.2020.11.023

Cited by 5 publications

(4 citation statements)

References 25 publications

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“…Informed by CFIR, this paper seeks to advance understanding of multi-level factors that shape uptake and delivery of naloxone/opioid training on college campuses. While there are a growing number of promising opioid/naloxone training programs being developed and evaluated on college campuses [ 53 – 55 , 60 , 66 ], particularly within professional graduate education [ 38 , 39 , 41 ], to our knowledge, this is the first theory-informed contextual assessment and evaluation of the key multi-level barriers and facilitators to implementation specifically on an undergraduate college campus.…”

Section: Discussionmentioning

confidence: 99%

Application of The Consolidated Framework for Implementation Research to inform understanding of barriers and facilitators to the implementation of opioid and naloxone training on college campuses

Shelton

Goodwin

McNeil

et al. 2023

Implement Sci Commun

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Background The opioid epidemic in the US continues to worsen. Opioid-only and polysubstance-involved opioid overdose deaths are increasing among adolescents and young adults, who have limited knowledge of opioid overdose prevention, including recognition and response. College campuses have infrastructure to support national-level implementation of evidence-based public health strategies for providing opioid overdose prevention and naloxone training programs among this priority population. However, college campuses are an underutilized, understudied setting for this programming. To address this gap, we conducted research assessing barriers and facilitators to planning and implementing this programming on college campuses. Methods We held 9 focus groups among purposively selected campus stakeholders whose perceptions were important to understand in planning for the dissemination and implementation of opioid overdose prevention and naloxone training. Focus group scripts were informed by The Consolidated Framework for Implementation Research (CFIR) to query about perceptions of opioid and other substance use, opioid and other substance use-related resources, and naloxone administration training. We used a deductive-inductive, iterative approach to thematic analysis. Results Themes about implementation barriers included (1) the perception that problematic use of other (non-opioid) substances was more prevalent than opioid use on campus and focus on those substances would be a greater priority on college campuses; (2) student schedules were overwhelmed with academic commitments and extracurricular activities, making delivery of additional training challenging; (3) barriers related to the perceived complexity and decentralization of communication on campus, preventing students from knowing how to access substance use-related resources. Themes about implementation facilitators included (1) framing naloxone training as important in becoming a responsible leader on campus and in the broader community and (2) leveraging existing infrastructure, champions within existing campus groups, and tailored messaging to facilitate participation in naloxone training. Conclusions This is the first study to provide in-depth insights into potential barriers and facilitators to widespread, routine implementation of naloxone/opioid education on undergraduate college campuses. The study captured diverse stakeholder perspectives and was theoretically grounded in CFIR, contributing to the growing literature on the application and refinement of CFIR across diverse community and school contexts.

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Section: Discussionmentioning

confidence: 99%

Application of The Consolidated Framework for Implementation Research to inform understanding of barriers and facilitators to the implementation of opioid and naloxone training on college campuses

Shelton

Goodwin

McNeil

et al. 2023

Implement Sci Commun

View full text Add to dashboard Cite

show abstract

“…In response to the passage of naloxone‐specific state legislation, many Doctor of Pharmacy (Pharm.D.) programs began incorporating naloxone training into part of the required curriculum 7 . Much of the literature focuses on training student pharmacists through a combination of traditional lecture and active learning in a lab environment or experiential setting followed by an assessment of the knowledge, perceived confidence in patient counseling, or perceived confidence in naloxone administration 8‐11 .…”

Section: Introductionmentioning

confidence: 99%

“…programs began incorporating naloxone training into part of the required curriculum. 7 Much of the literature focuses on training student pharmacists through a combination of traditional lecture and active learning in a lab environment or experiential setting followed by an assessment of the knowledge, perceived confidence in patient counseling, or perceived confidence in naloxone administration. [8][9][10][11] Furthermore, several studies complete the follow-up assessment within 1 year of initial instruction.…”

mentioning

confidence: 99%

Assessment of the acute‐ and long‐term application of naloxone training on a simulated overdose response

Franko

2022

J Am Coll Clin Pharm

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Introduction Pharmacist training on naloxone is often assessed within a year of initial instruction, however, the retention of the skills necessary in a naloxone rescue beyond this time frame has not been well established. Objective The aim of this study was to determine the acute‐ vs long‐term application of naloxone training on a simulated overdose response. Methods Pharmacy students in their first professional year (P1) were provided asynchronous training on naloxone information and use 2 days prior to a required skills lab. During the lab, students completed an overdose simulation with naloxone response. Students in their third professional year (P3) had a required skills lab focused on substance use disorders at the same time as the P1 lab. These students, who received the same training as the current P1's 2 years prior, completed the same overdose simulation with naloxone response during their scheduled lab time. A checklist from previously published work was used to evaluate student performance during each simulation. Results of the P1 and P3 simulations were compared. Results One hundred percent of P1 students (n = 65) and 97% of P3 students (n = 65) consented to have their data used as part of the study. The median scores for the simulation were 82% (interquartile range [IQR] = 9) for the P1 students and 73% (IQR = 9) for the P3 students (p = 0.58). A significant difference between the groups existed for two items on the checklist: assess the scene is safe (P1 = 52%, P3 = 26%, p = 0.002), and determine if the patient is breathing (P1 = 18%, P3 = 34%, p = 0.04). Conclusion Students who received initial instruction on naloxone use 2 years prior to a simulated naloxone rescue demonstrated similar results to those who received initial instruction 2 days prior to the same simulation.

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“…In response to the passage of naloxone specific state legislation, several Doctor of Pharmacy programs began incorporating naloxone training as part of the required curriculum 7 . Much of the literature focuses on training student pharmacists through a combination of traditional lecture and active learning in a lab environment or experiential setting, followed by an assessment of perceived confidence in the ability to counsel on naloxone use 8‐11 .…”

Section: Introductionmentioning

confidence: 99%

Effect of a simulated overdose response on student ability to counsel on naloxone use

Franko

2021

J Am Coll Clin Pharm

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Introduction Pharmacist training on naloxone is often assessed by determining perceptions of self‐confidence in counseling; however, the impact of a specific training on counseling quality has not been well established. Objective The aim of this study was to determine if completing a simulated overdose with naloxone response results in an improved ability to counsel a patient on naloxone use. Methods Students in the third professional year were provided live training on naloxone information and use as part of a required skills lab. Immediately afterward, students were randomized to complete an overdose simulation with naloxone response or to counsel an individual on naloxone use. Following completion of their initial activity, students then completed the other. A checklist adapted from previously published work and the recommended naloxone training from the Commonwealth of Pennsylvania was used to assess the counseling session. Counseling results of students who completed the overdose simulation first were compared with those who completed the simulation second. Results Here, 100% of eligible students (N = 138) participated in the simulation and 134 (97%) participated in the counseling session. The median scores for the counseling activity were 82% (interquartile range [IQR] = 27%) for students who completed the simulation prior to counseling and 82% (IQR = 27%) for students who did not complete the simulation prior to counseling (P = .61). Furthermore, there were no statistically significant differences between any checklist item among the two groups. Conclusion There was no difference in counseling ability between students who completed a simulated naloxone response and those who did not. Additional research is needed to better determine the effect of simulation on patient counseling skills. As naloxone training programs are further refined, consideration should be given to streamline the process to include evidence‐based methods of training which result in improved skills in both administration and counseling.

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Educational programs implemented for pharmacists after state passage of a standing order for naloxone: A systematic review of current practices

Cited by 5 publications

References 25 publications

Application of The Consolidated Framework for Implementation Research to inform understanding of barriers and facilitators to the implementation of opioid and naloxone training on college campuses

Application of The Consolidated Framework for Implementation Research to inform understanding of barriers and facilitators to the implementation of opioid and naloxone training on college campuses

Assessment of the acute‐ and long‐term application of naloxone training on a simulated overdose response

Effect of a simulated overdose response on student ability to counsel on naloxone use

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