Journal article
Pharmacist counseling when dispensing naloxone by standing order: A secret shopper study of 4 chain pharmacies
Journal of the American Pharmacists Association, Vol.61(2), pp.E94-E99
03/01/2021
DOI: 10.1016/j.japh.2020.10.010
PMID: 33153912
Abstract
Background: Texas has passed legislation to increase access to naloxone, the opioid overdose antidote, allowing pharmacists to dispense by standing order without an outside prescription. Given this added responsibility, there is a need to assess real-world counseling provided by pharmacists when dispensing naloxone.
Objectives: Assess naloxone accessibility and counseling provided by community pharmacists when dispensing naloxone by standing order.
Methods: Atotal of 11 student pharmacists (mean age 25 years; 63.6% female; primarily Hispanic [36.4%], Asian [27.3%], and white [27.3%]) audited community pharmacies by presenting to purchase naloxone. Variables included naloxone availability and price, counseling duration, and whether 13 predetermined counseling points were provided unprompted. Shoppers were prepared with a background story if asked so that each answered questions consistently. All shoppers participated in two 1-hour training sessions, including verification of their ability to accurately assess naloxone counseling. Pharmacies in Bexar County, TX were selected randomly from 4 pharmacy chains, each of which have implemented statewide standing orders within their chain. Descriptive statistics were calculated. A Fisher exact test and linear mixed-effects regression model were used to assess variation across chains in whether naloxone was dispensed and the mean total number of counseling points provided, respectively.
Results: The shoppers audited 45 pharmacies. Naloxone was dispensed in 31 of 45 (68.9%) encounters (mean cost: $129.59). The mean counseling duration was 89 seconds. The most common counseling points included: administration technique (24 of 31), readministration of second dose (22 of 31), and calling 9-1-1 (20 of 31). All other points were included in less than one-third of pharmacists' counseling. Across the 4 chains, there was significant variation in naloxone dispensing and the number of counseling points provided.
Conclusion: Secret shoppers were unable to access naloxone from nearly one-third of pharmacies. Counseling often excluded concepts pertinent to patient safety and effectiveness, suggesting opportunities remain to promote consistent, high-quality naloxone counseling in community pharmacies. (C) 2021 American Pharmacists Association (R). Published by Elsevier Inc. All rights reserved.
Details
- Title: Subtitle
- Pharmacist counseling when dispensing naloxone by standing order: A secret shopper study of 4 chain pharmacies
- Creators
- Jillian Contreras - Univ Texas Austin, Coll Pharm, Austin, TX 78712 USACourtney Baus - Univ Texas Austin, Coll Pharm, Austin, TX 78712 USAClaire Brandt - Univ Texas Austin, Coll Pharm, Austin, TX 78712 USAMatthew Witry - University of IowaJoanne Peters - University of Wisconsin–MadisonKirk E. Evoy - Univ Texas Austin, Coll Pharm, Austin, TX 78712 USA
- Resource Type
- Journal article
- Publication Details
- Journal of the American Pharmacists Association, Vol.61(2), pp.E94-E99
- Publisher
- Elsevier
- DOI
- 10.1016/j.japh.2020.10.010
- PMID
- 33153912
- ISSN
- 1544-3191
- eISSN
- 1544-3450
- Number of pages
- 6
- Grant note
- Baptist Health Foundation of San Antonio Center for Medical Humanities and Ethics
- Language
- English
- Date published
- 03/01/2021
- Academic Unit
- Pharmacy Practice and Science; Internal Medicine
- Record Identifier
- 9984359670202771
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