Pharmacists’ naloxone offering and dispensing practices

Objective: The primary objective of this paper is to understand pharmacists’ naloxone offering and dispensing practices and factors affecting those practices. The secondary objective of this paper is to refine an existing survey instrument and use it to understand pharmacists’ naloxone offering and dispensing behaviors and factors affecting it.Design, settings, and participants: A statewide mail survey of pharmacists was conducted in Wisconsin using stratified random sampling. Survey data were analyzed using descriptive statistics to understand pharmacists’ naloxone offering and dispensing practices and multiple regression analysis to understand factors affecting these practices.Main outcomes: (1) Pharmacists’ practices about naloxone offering and dispensing; (2) factors affecting these practices. Results: Most pharmacies stocked naloxone (92.9 percent) and were under the Wisconsin standing order (80.1 percent). The majority of pharmacists reported that they occasionally (36.6 percent), rarely (29.3 percent), or never (21.5 percent) offer naloxone to patients. The majority reported that they occasionally (29.3 percent), rarely (52.4 percent), or never (15.2 percent) dispense naloxone. While most pharmacists were confident in their ability to initiate conversations about naloxone, they were not confident on how to screen patients at risk for opioid overdose. Pharmacists offered naloxone more when they felt more confident initiating a conversation regarding the need for naloxone with patients (β = 0.50, p <0.05). Pharmacists dispensed naloxone more when they have had more previous training about dispensing naloxone (β = 0.43, p <0.05).Conclusion: Many pharmacists hardly offer or dispense naloxone under the standing order. Pharmacists may benefit from standardized training and resources about screening patients for risk of overdose and overdose risk communication.