Objective: Each U.S. state and the District of Columbia has passed legislation expanding access to naloxone, the opioid overdose antidote. Most naloxone access laws allow for standing orders, whereby prescribers may authorize pharmacists to dispense naloxone without an outside prescription. A recent study from our group assessing naloxone accessibility via standing order identified continued access barriers. The present study assessed whether brief, in-person, student-led academic detailing of community pharmacists improved naloxone accessibility.
Methods: A telephone audit of all 2317 CVS, Walgreens, H-E-B, and Walmart pharmacies in Texas was conducted to determine naloxone accessibility under standing orders. Within 2 months following the initial audit, student pharmacists visited the Austin and San Antonio, Texas area pharmacies that indicated they would not dispense naloxone without a prescription, to provide brief (< 5 minutes) academic detailing to the pharmacist on duty. Students followed a scripted outline designed to inform pharmacists about naloxone standing orders and naloxone use for opioid overdose response. Then they provided a flyer and requested that it be displayed in the pharmacy to inform patients about naloxone. An identical telephone audit was conducted 1-2 weeks following the education.
Results: Of the 49 pharmacies receiving education, 37 (76%) responded that they would dispense naloxone without an outside prescription appropriately. When comparing each pharmacy before and after detailing, respectively, it was observed that 51% versus 71% (P = 0.008) stocked naloxone; 43% versus 71% (P = 0.002) would dispense naloxone to a third-party customer; and 12% versus 37% (P = 0.005) would submit a claim to the insurance of a third-party customer.
Conclusion: Student-led academic detailing was effective in improving pharmacists' willingness to dispense naloxone under standing orders and increasing naloxone accessibility from community pharmacies. Studies beyond Texas chain pharmacies are warranted to validate the effectiveness of this technique on a larger scale.
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