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Association Between a State Law Allowing Pharmacists to Dispense Naloxone Without a Prescription and Naloxone Dispensing Rates.
Gangal, Neha S; Hincapie, Ana L; Jandarov, Roman; Frede, Stacey M; Boone, Jill M; MacKinnon, Neil J; Koechlin, Kathleen; DeFiore-Hyrmer, Jolene; Holthusen, Amy; Heaton, Pamela C.
Afiliación
  • Gangal NS; Department of Pharmacy Practice and Administrative Sciences, Winkle College of Pharmacy, University of Cincinnati, Cincinnati, Ohio.
  • Hincapie AL; Department of Pharmacy Practice and Administrative Sciences, Winkle College of Pharmacy, University of Cincinnati, Cincinnati, Ohio.
  • Jandarov R; Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio.
  • Frede SM; Clinical Program Development, Kroger Health, Cincinnati, Ohio.
  • Boone JM; Department of Pharmacy Practice and Administrative Sciences, Winkle College of Pharmacy, University of Cincinnati, Cincinnati, Ohio.
  • MacKinnon NJ; Department of Pharmacy Practice and Administrative Sciences, Winkle College of Pharmacy, University of Cincinnati, Cincinnati, Ohio.
  • Koechlin K; Violence & Injury Prevention Section, Ohio Department of Health, Columbus.
  • DeFiore-Hyrmer J; Violence & Injury Prevention Section, Ohio Department of Health, Columbus.
  • Holthusen A; Project DAWN, Violence & Injury Prevention Section, Ohio Department of Health, Columbus (at time of study).
  • Heaton PC; Division of Pharmacy Practice and Administrative Sciences, Winkle College of Pharmacy, University of Cincinnati, Cincinnati, Ohio.
JAMA Netw Open ; 3(1): e1920310, 2020 01 03.
Article en En | MEDLINE | ID: mdl-32003819
Importance: Between 2015 and 2017, Ohio had the second highest number of opioid-related deaths. In July 2015, the Ohio General Assembly approved a law allowing pharmacists to dispense naloxone without a prescription in accordance with a physician-approved protocol. This change in the law allowed pharmacists to have more opportunity to participate in the management of patients who were addicted to opioids. Objective: To determine the association between the implementation of an Ohio law allowing pharmacists to dispense naloxone without a prescription in accordance with a physician-approved protocol and naloxone dispensing rates. Design, Setting, and Participants: A segmented regression analysis of an interrupted time series was performed for 30 consecutive months to evaluate the change in the naloxone dispensing rate before and after the implementation of the state law. Ohio Medicaid naloxone claims and Kroger Pharmacy naloxone claims for all 88 counties in Ohio were examined. Any patient 18 years or older with at least 1 naloxone order dispensed through Ohio Medicaid or by a Kroger Pharmacy in Ohio during the study period of July 16, 2014, to January 15, 2017, was included in the study. Data were analyzed from April 23, 2018, to July 7, 2019. Exposures: The primary independent variable was implementation of an Ohio law allowing pharmacists to dispense naloxone without a prescription in accordance with a physician-approved protocol, which took effect in July 2015. Main Outcomes and Measures: The primary outcome measure was the naloxone dispensing rate per month per county. Results: In the Ohio Medicaid population, the number of naloxone orders dispensed after the policy was implemented increased by 2328%, from 191 in the prepolicy period to 4637 in the postpolicy period. The rate of naloxone orders dispensed per month per county after the policy was implemented increased by 4% in the Ohio Medicaid population and 3% in the Kroger Pharmacy population compared with the prepolicy period. The rate of naloxone orders dispensed after the policy was implemented increased by 18% per month in low-employment counties compared with high-employment counties in the Ohio Medicaid population. Conclusions and Relevance: The implementation of a state law allowing pharmacists to dispense naloxone without a prescription in accordance with a physician-approved protocol was associated with an increase in the number of naloxone orders dispensed in the Ohio Medicaid and Kroger Pharmacy populations. Moreover, a significant increase was observed in the naloxone dispensing rate among the Ohio Medicaid population in counties with low employment and high poverty.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Prescripciones de Medicamentos / Pautas de la Práctica en Medicina / Sobredosis de Droga / Naloxona / Antagonistas de Narcóticos Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: JAMA Netw Open Año: 2020 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Prescripciones de Medicamentos / Pautas de la Práctica en Medicina / Sobredosis de Droga / Naloxona / Antagonistas de Narcóticos Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: JAMA Netw Open Año: 2020 Tipo del documento: Article Pais de publicación: Estados Unidos