Highlights
- Take-home naloxone may be expanded through community pharmacy.
- Early work indicates pharmacists are willing to supply naloxone.
- Existing models for community pharmacy of naloxone supply exist.
- Supply models have important cost implications for consumers.
- Larger implementation studies are needed to determine effectiveness.
Background
There
is growing evidence that expanded supply of take-home naloxone to prevent
opioid overdose deaths is needed. Potential routes for expansion of naloxone
provision include through community pharmacies. The aim of this scoping review
is to establish what is known about community pharmacy supply of naloxone, in
light of unique challenges and opportunities present in pharmacy settings.
Methods
A
scoping review methodology was employed using the six stage iterative process
advocated by Arksey and O’ Malley (2005) and Levac et al. (2010). Searches used
key words and terms such as ‘naloxone’; ‘overdose prevention/drug
overdose/opiate overdose’; ‘community/retail pharmacy’;
‘pharmacist/pharmacy/community pharmacy/pharmaceutical services’; ‘professional
practice/role’; ‘community care’; attitude of health personnel’;
‘training/supply/cost’). Appropriate search terms were selected for each
database. After initial exploratory searches, comprehensive searches were
conducted with Cochrane Database of Systematic Reviews, Medline, Medline in
Process, Embase, PsycINFO and CINAHL. Eligibility criteria centered on whether
studies broadly described supply of naloxone in community pharmacy or had
content relating to community pharmacy supply.
Results
The
search identified 95 articles, of which 16 were related to pharmacy supply of
naloxone. Five themes were presented after initial review of the data and
consultation with the project Expert Group, and are; ‘Pharmacists Perceptions
of Naloxone: Facilitators and Barriers’, ‘Patient Populations: Identification
and Recruitment’, ‘Supply Systems and Cost’, ‘Legal Issues’, and ‘Training of
Pharmacists and Community Pharmacy Naloxone Recipients’.
Conclusion
The
community pharmacy based route for distribution of take home naloxone provision
warrants further consideration and development. Existing strengths include a
range of established supply models, and training curricula, few direct concerns
regarding legal liability of pharmacists in the supply of naloxone (once legal
supply systems have been established) and the wide range of potential
identifiable patient populations, which include pain patients that may not be
in contact with existing naloxone supply programmes.
Purchase full article at: http://goo.gl/G49VMg
Affiliations
- National Drug and Alcohol Research Centre, University of New South Wales, Australia
- Drug and Alcohol Services, South Eastern Sydney Local Health District
Correspondence
- Corresponding author.at: National Drug and Alcohol Research Centre University of New South Wales Sydney 2052, Australia.
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