A pharmacist-led intervention of dispensing naloxone to a patient population at risk of opioid-related harm

Background: Even though pharmacists are fully capable of dispensing naloxone under protocols, there are barriers perceived by pharmacists, such as determining which patients are at high-risk.

Objective(s): The study objectives were to 1) determine the impact of pharmacist-led identification of patients at a high-risk of opioid-related harm and pharmacist intervention by providing naloxone counseling; and 2) identify patient-reported barriers for receiving naloxone recommended by pharmacists under the Missouri Standing Protocol.

Methods: Pharmacists developed a standardized process in their workflow to identify patients at high-risk of opioid-related harm defined by the Centers for Disease Control and Prevention guidelines, and attempted to call the patient prior to the patient's arrival to counsel the patient on naloxone. Primary outcomes included the number of at-risk patients identified, the number of patients who were willing to receive naloxone, and the number of patients who picked up naloxone at the pharmacy. Secondary outcomes included patient-reported barriers. Descriptive statistics, bivariate correlations, and chi-square tests were used to analyze the data.

Results: Fifty patients participated in the study, of whom the average age was 56 years, 52% were male, and 56% were African American. Forty-one patients were willing to receive naloxone from pharmacists under the Missouri Standing Protocol, and 36 were dispensed naloxone from the pharmacy. Fourteen patients reported barriers to receiving naloxone, including transportation, cost, and waiting time at the pharmacy. The correlations show that not understanding need and not wanting to keep naloxone on hand were negatively associated with the patient's willingness to receive naloxone (P < 0.01). Chi-squared tests supported the relationships revealed by the correlations.

Conclusion: Pharmacists were able to identify patients who were at high-risk for opioid-related harm and then counseled them on naloxone. Pharmacists also identified patient-reported barriers to further expand access to naloxone.