Opioid overdose counseling and prescribing of naloxone in rural community pharmacies: A pilot study

Introduction: Fatal overdoses from opioids increased four-fold from 1999 to 2009, and they are now the leading cause of death among Americans under 50. Legislation has been passed by every state to increase access to naloxone but dispensing by community pharmacies remains low. Objectives: The object...

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Main Authors: Benjamin S. Teeter, Mary M. Thannisch, Bradley C. Martin, Nickolas D. Zaller, Duane Jones, Cynthia L. Mosley, Geoffrey M. Curran
Format: Article
Language:English
Published: Elsevier 2021-06-01
Series:Exploratory Research in Clinical and Social Pharmacy
Online Access:http://www.sciencedirect.com/science/article/pii/S2667276621000196
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author Benjamin S. Teeter
Mary M. Thannisch
Bradley C. Martin
Nickolas D. Zaller
Duane Jones
Cynthia L. Mosley
Geoffrey M. Curran
author_facet Benjamin S. Teeter
Mary M. Thannisch
Bradley C. Martin
Nickolas D. Zaller
Duane Jones
Cynthia L. Mosley
Geoffrey M. Curran
author_sort Benjamin S. Teeter
collection DOAJ
description Introduction: Fatal overdoses from opioids increased four-fold from 1999 to 2009, and they are now the leading cause of death among Americans under 50. Legislation has been passed by every state to increase access to naloxone but dispensing by community pharmacies remains low. Objectives: The objective of this study was to pilot test a proactive opioid overdose counseling intervention and a passive naloxone intervention, and the implementation strategies developed to support their delivery, in rural community pharmacies on relevant implementation outcomes. Methods: The interventions, implementation strategies, and the overall pilot study approach were developed in a collaborative partnership with a regional supermarket pharmacy chain. They selected 2 rural pharmacies to participate in the pilot study and 2 non-intervention pharmacies to serve as comparison sites. Two interventions were pilot tested in the 2 intervention pharmacies: 1) a proactive opioid overdose counseling intervention and 2) a passive naloxone intervention. An explanatory sequential mixed-methods design was utilized to evaluate adoption, feasibility, acceptability, and appropriateness outcomes after the 3-month observation period. Results: Between the 2 intervention pharmacies, 130 patients received the opioid overdose counseling intervention. 44 (33.8%) were prescribed and dispensed naloxone. Zero naloxone prescriptions were written or dispensed at the comparison pharmacies. Interviews with pharmacy staff found the interventions to be feasible, acceptable, and appropriate in their settings. Conclusion: This small scale pilot study in partnership with a regional supermarket pharmacy chain had positive results with a third of patients who received the opioid overdose counseling intervention being dispensed naloxone. However, the majority of patients did not receive naloxone indicating additional revisions to the intervention components and/or implementation strategies are needed to improve the overall impact of the interventions.
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spelling doaj.art-bf8387c61dc5400db42b47d17cb2b9032022-12-21T21:25:45ZengElsevierExploratory Research in Clinical and Social Pharmacy2667-27662021-06-012100019Opioid overdose counseling and prescribing of naloxone in rural community pharmacies: A pilot studyBenjamin S. Teeter0Mary M. Thannisch1Bradley C. Martin2Nickolas D. Zaller3Duane Jones4Cynthia L. Mosley5Geoffrey M. Curran6Center for Implementation Research, Department of Pharmacy Practice, University of Arkansas for Medical Sciences, Little Rock, AR 72205, United States of America; Corresponding author at: 4301 W. Markham St., #522, Little Rock, AR 72205-7199, United States of America.University of Arkansas for Medical Sciences, Little Rock, AR 72205, United States of AmericaDivision of Pharmaceutical Evaluation and Policy, Department of Pharmacy Practice, University of Arkansas for Medical Sciences, Little Rock, AR 72205, United States of AmericaFay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR 72205, United States of AmericaHarps Food Stores, Inc., Springdale, AR 72762, United States of AmericaCenter for Implementation Research, Department of Pharmacy Practice, University of Arkansas for Medical Sciences, Little Rock, AR 72205, United States of AmericaCenter for Implementation Research, Departments of Pharmacy Practice and Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR 72205, United States of America; Central Arkansas Veterans Healthcare System, 2200 Fort Roots Drive, North Little Rock, AR 72114, United States of AmericaIntroduction: Fatal overdoses from opioids increased four-fold from 1999 to 2009, and they are now the leading cause of death among Americans under 50. Legislation has been passed by every state to increase access to naloxone but dispensing by community pharmacies remains low. Objectives: The objective of this study was to pilot test a proactive opioid overdose counseling intervention and a passive naloxone intervention, and the implementation strategies developed to support their delivery, in rural community pharmacies on relevant implementation outcomes. Methods: The interventions, implementation strategies, and the overall pilot study approach were developed in a collaborative partnership with a regional supermarket pharmacy chain. They selected 2 rural pharmacies to participate in the pilot study and 2 non-intervention pharmacies to serve as comparison sites. Two interventions were pilot tested in the 2 intervention pharmacies: 1) a proactive opioid overdose counseling intervention and 2) a passive naloxone intervention. An explanatory sequential mixed-methods design was utilized to evaluate adoption, feasibility, acceptability, and appropriateness outcomes after the 3-month observation period. Results: Between the 2 intervention pharmacies, 130 patients received the opioid overdose counseling intervention. 44 (33.8%) were prescribed and dispensed naloxone. Zero naloxone prescriptions were written or dispensed at the comparison pharmacies. Interviews with pharmacy staff found the interventions to be feasible, acceptable, and appropriate in their settings. Conclusion: This small scale pilot study in partnership with a regional supermarket pharmacy chain had positive results with a third of patients who received the opioid overdose counseling intervention being dispensed naloxone. However, the majority of patients did not receive naloxone indicating additional revisions to the intervention components and/or implementation strategies are needed to improve the overall impact of the interventions.http://www.sciencedirect.com/science/article/pii/S2667276621000196
spellingShingle Benjamin S. Teeter
Mary M. Thannisch
Bradley C. Martin
Nickolas D. Zaller
Duane Jones
Cynthia L. Mosley
Geoffrey M. Curran
Opioid overdose counseling and prescribing of naloxone in rural community pharmacies: A pilot study
Exploratory Research in Clinical and Social Pharmacy
title Opioid overdose counseling and prescribing of naloxone in rural community pharmacies: A pilot study
title_full Opioid overdose counseling and prescribing of naloxone in rural community pharmacies: A pilot study
title_fullStr Opioid overdose counseling and prescribing of naloxone in rural community pharmacies: A pilot study
title_full_unstemmed Opioid overdose counseling and prescribing of naloxone in rural community pharmacies: A pilot study
title_short Opioid overdose counseling and prescribing of naloxone in rural community pharmacies: A pilot study
title_sort opioid overdose counseling and prescribing of naloxone in rural community pharmacies a pilot study
url http://www.sciencedirect.com/science/article/pii/S2667276621000196
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