Barriers and facilitators to dispensing of intranasal naloxone by pharmacists.

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  • Additional Information
    • Subject Terms:
    • Author-Supplied Keywords:
      Naloxone
      opioids
      pharmacists
      pharmacy-based interventions
    • NAICS/Industry Codes:
      446110 Pharmacies and Drug Stores
      414510 Pharmaceuticals and pharmacy supplies merchant wholesalers
      325410 Pharmaceutical and medicine manufacturing
    • Abstract:
      Background: Although misuse of prescription opioids has reached epidemic proportions, pharmacy-based preventive services to combat this epidemic are limited. The aims of this study were to identify barriers and facilitators to the dispensing of intranasal naloxone (INN) by pharmacists in New Mexico. Methods: For this mixed-methods study, a qualitative component (focus group) informed the development of a quantitative component (electronic survey) distributed to all pharmacists registered with the New Mexico Board of Pharmacy and practicing in the state. A 46-item survey included questions about pharmacists' concerns regarding dispensing INN, barriers and facilitators to dispensing INN, efforts needed to increase availability and utilization of pharmacist-dispensed INN, and characteristics of respondents and their pharmacies. Results: Pharmacists from all geographical regions and all types of pharmacy settings were represented in the sample (final N = 390, participation rate 23.5%, including a subset of 182 community pharmacists). The main barriers identified were (1) out-of-pocket costs for patients; (2) time constraints for pharmacists; and (3) inadequate reimbursement for pharmacists. The main facilitators were (1) increased awareness among opioid-using patients and family members about the need for INN; (2) additional education to the general public; and (3) additional training for pharmacists on how to initiate discussions about INN with high-risk patients. Some community pharmacists were concerned that INN dispensing would promote opioid abuse (16.5%) and attract undesirable clientele (14.3%). In a multivariable logistic regression analysis of a community pharmacy subset, a higher number of concerns about INN (odds ratio [OR] = 0.87; 95% confidence interval [CI]: 0.82-0.93) and a pharmacy setting in a chain grocery or a "big box" store (OR = 0.38; 95% CI: 0.16-0.92) were associated with decreased odds of dispensing INN. Conclusions: Effective intervention strategies for increasing dispensing of intranasal naloxone by pharmacists should focus on pharmacists' concerns, include education to multiple audiences, and address provider-level, system-level, and society-level barriers. [ABSTRACT FROM AUTHOR]
    • Abstract:
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    • Author Affiliations:
      1Department of Pharmacy Practice and Administrative Sciences, College of Pharmacy, University of New Mexico, Albuquerque, New Mexico, USA
      2Department of Family and Community Medicine, School of Medicine, University of New Mexico, Albuquerque, New Mexico, USA
      3Department of Pediatrics, School of Medicine, University of New Mexico, Albuquerque, New Mexico, USA
    • Full Text Word Count:
      8028
    • ISSN:
      0889-7077
    • Accession Number:
      10.1080/08897077.2017.1391924
    • Accession Number:
      134347135
  • Citations
    • ABNT:
      BAKHIREVA, L. N. et al. Barriers and facilitators to dispensing of intranasal naloxone by pharmacists. Substance Abuse, [s. l.], v. 39, n. 3, p. 331–341, 2018. DOI 10.1080/08897077.2017.1391924. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=aph&AN=134347135. Acesso em: 8 abr. 2020.
    • AMA:
      Bakhireva LN, Bautista A, Cano S, Shrestha S, Bachyrycz AM, Cruz TH. Barriers and facilitators to dispensing of intranasal naloxone by pharmacists. Substance Abuse. 2018;39(3):331-341. doi:10.1080/08897077.2017.1391924.
    • APA:
      Bakhireva, L. N., Bautista, A., Cano, S., Shrestha, S., Bachyrycz, A. M., & Cruz, T. H. (2018). Barriers and facilitators to dispensing of intranasal naloxone by pharmacists. Substance Abuse, 39(3), 331–341. https://doi.org/10.1080/08897077.2017.1391924
    • Chicago/Turabian: Author-Date:
      Bakhireva, Ludmila N., Adriana Bautista, Sandra Cano, Shikhar Shrestha, Amy M. Bachyrycz, and Theresa H. Cruz. 2018. “Barriers and Facilitators to Dispensing of Intranasal Naloxone by Pharmacists.” Substance Abuse 39 (3): 331–41. doi:10.1080/08897077.2017.1391924.
    • Harvard:
      Bakhireva, L. N. et al. (2018) ‘Barriers and facilitators to dispensing of intranasal naloxone by pharmacists’, Substance Abuse, 39(3), pp. 331–341. doi: 10.1080/08897077.2017.1391924.
    • Harvard: Australian:
      Bakhireva, LN, Bautista, A, Cano, S, Shrestha, S, Bachyrycz, AM & Cruz, TH 2018, ‘Barriers and facilitators to dispensing of intranasal naloxone by pharmacists’, Substance Abuse, vol. 39, no. 3, pp. 331–341, viewed 8 April 2020, .
    • MLA:
      Bakhireva, Ludmila N., et al. “Barriers and Facilitators to Dispensing of Intranasal Naloxone by Pharmacists.” Substance Abuse, vol. 39, no. 3, July 2018, pp. 331–341. EBSCOhost, doi:10.1080/08897077.2017.1391924.
    • Chicago/Turabian: Humanities:
      Bakhireva, Ludmila N., Adriana Bautista, Sandra Cano, Shikhar Shrestha, Amy M. Bachyrycz, and Theresa H. Cruz. “Barriers and Facilitators to Dispensing of Intranasal Naloxone by Pharmacists.” Substance Abuse 39, no. 3 (July 2018): 331–41. doi:10.1080/08897077.2017.1391924.
    • Vancouver/ICMJE:
      Bakhireva LN, Bautista A, Cano S, Shrestha S, Bachyrycz AM, Cruz TH. Barriers and facilitators to dispensing of intranasal naloxone by pharmacists. Substance Abuse [Internet]. 2018 Jul [cited 2020 Apr 8];39(3):331–41. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=aph&AN=134347135