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      Naloxone Accessibility Without a Prescriber Encounter Under Standing Orders at Community Pharmacy Chains in Texas

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      JAMA
      American Medical Association (AMA)

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          Abstract

          <p class="first" id="d3782575e256">This study evaluated naloxone accessibility from chain pharmacies in Texas 32 months after state legislation allowing pharmacists to dispense naloxone under standing orders from authorizing prescribers. </p>

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          Predicting pharmacy naloxone stocking and dispensing following a statewide standing order, Indiana 2016

          Background: While naloxone, the overdose reversal medication, has been available for decades, factors associated with its availability through pharmacies remain unclear. Studies suggest that policy and pharmacist beliefs may impact availability. Indiana passed a standing order law for naloxone in 2015 to increase access to naloxone. Objective: To identify factors associated with community pharmacy naloxone stocking and dispensing following the enactment of a statewide naloxone standing order. Methods: A 2016 cross-sectional census of Indiana community pharmacists was conducted following a naloxone standing order. Community, pharmacy, and pharmacist characteristics, and pharmacist attitudes about naloxone dispensing, access, and perceptions of the standing order were measured. Modified Poisson and binary logistic regression models attempted to predict naloxone stocking and dispensing, respectively. Results: Over half (58.1%) of pharmacies stocked naloxone, yet 23.6% of pharmacists dispensed it. Most (72.5%) pharmacists believed the standing order would increase naloxone stocking, and 66.5% believed it would increase dispensing. Chain pharmacies were 3.2 times as likely to stock naloxone. Naloxone stocking was 1.6 times as likely in pharmacies with more than one full-time pharmacist. Pharmacies where pharmacists received naloxone continuing education in the past two years were 1.3 times as likely to stock naloxone. The attempted dispensing model yielded no improvement over the constant-only model. Conclusions: Pharmacies with larger capacity took advantage of the naloxone standing order. Predictors of pharmacist naloxone dispensing should continue to be explored to maximize naloxone access.
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            Author and article information

            Journal
            JAMA
            JAMA
            American Medical Association (AMA)
            0098-7484
            November 13 2018
            November 13 2018
            : 320
            : 18
            : 1934
            Affiliations
            [1 ]College of Pharmacy, The University of Texas at Austin
            Article
            10.1001/jama.2018.15892
            6248133
            30422186
            416010ac-19eb-41ff-adc9-28833016fc69
            © 2018
            History

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