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How pharmacists can increase naloxone distribution, reduce opioid-related harms

June 7, 2019

Life-saving drug prevents overdose from various opioids

BOSTON — A new research study led by Boston Medical Center’s Injury Prevention Center and Grayken Center for Addiction will help combat the opioid epidemic by measuring pharmacists’ most effective methods for naloxone education and distribution. RESPOND TO PREVENT combines two pharmacy-specific educational interventions that have shown promise in reducing opioid-related harms, and this study will investigate the impact of the approach by deploying it at pharmacies across the country.

The RESPOND TO PREVENT training program will address both safe opioid and naloxone dispensing at the pharmacy-level to reduce opioid-related harms for all individuals, regardless of whether they are using illicit drugs or prescribed opioids for pain or opioid use disorder management. Naloxone can be administered by injection into a muscle or as a nasal spray (sold as the brand name Narcan™) to prevent overdose death from any type of opioid.

Through the first program, called RESPOND (Resources Encouraging Safe Prescription Opioid and Naloxone Dispensing), pharmacists will deploy tools they can use to more effectively screen for opioid medication risks and determine how to engage in sometimes difficult conversations with patients around opioid safety. The second program, MOON (Maximizing Opioid Safety with Naloxone), utilizes pharmacy-based resources to enhance patient education and uptake of naloxone, a medication that reverses opioid overdose.

“Every state in the country has quickly adopted laws to expand access to naloxone in the pharmacy, but changing a law isn’t always enough to change behavior or a patient’s experience,” explained Traci Green, PhD, MSc, the study’s principal investigator and an associate professor of emergency medicine and community health sciences at the Boston University Schools of Medicine and Public Health. “Pharmacies are a comprehensive and trusted health resource in every community, and this study will help us learn how best to equip pharmacists to address opioid safety.”

RESPOND TO PREVENT will be delivered through 160 CVS Pharmacy and Albertsons Companies locations across Massachusetts, New Hampshire, Oregon and Washington, with up to 480 pharmacists involved. Through the program, pharmacists will use tools to improve communication with patients on safe opioid use, how to minimize bad reactions, and respond in a medication emergency, including by using naloxone. The research team will investigate how pharmacists discuss naloxone with patients, and measure how often they dispense it, with the goal to significantly improve naloxone distribution and education in pharmacies.

The national opioid epidemic has become increasingly urgent as the number of opioid overdose deaths continue to rise. Opioids include prescription medications such as oxycodone and buprenorphine, as well as illicit drugs like heroin and fentanyl. According to the most recent data from the Centers for Disease Control, pain medication prescribing rates are currently declining while illicit opioid use is on the rise, placing more emphasis on risk management strategies to reduce the number of opioid-related deaths.

The project is led by Dr. Green, and additional collaborators include Comagine Health, University of Washington, Oregon Health & Science University College of Pharmacy, Oregon State University, and the University of Rhode Island College of Pharmacy. The study is supported by a $2.6 million grant from the National Institutes of Health’s National Institute on Drug Abuse.

About Boston Medical Center

Boston Medical Center is a private, not-for-profit, 514-bed, academic medical center that is the primary teaching affiliate of Boston University School of Medicine. It is the largest and busiest provider of trauma and emergency services in New England. Boston Medical Center offers specialized care for complex health problems and is a leading research institution, receiving more than $116 million in sponsored research funding in fiscal year 2017. It is the 15th largest recipient of funding in the U.S. from the National Institutes of Health among independent hospitals. In 1997, BMC founded Boston Medical Center Health Plan, Inc., now one of the top ranked Medicaid MCOs in the country, as a non-profit managed care organization. Boston Medical Center and Boston University School of Medicine are partners in the Boston HealthNet — 14 community health centers focused on providing exceptional health care to residents of Boston. For more information, please visit http://www.bmc.org.

About Comagine Health (formerly Qualis Health and HealthInsight)

Comagine Health works collaboratively with patients, providers, payers and other stakeholders to reimagine, redesign and implement sustainable improvements in the health care system. As a trusted, neutral party, we work in our communities to address key, complex health and health care delivery problems. In all our engagements and initiatives, we draw upon our expertise in quality improvement, care management, health information technology, analytics and research. We invite our partners and communities to work with us to improve health and redesign the health care delivery system. For more information, please visit https://comagine.org.

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