Impact of naloxone education for patients receiving buprenorphine-containing prescriptions indicated for opioid use disorder at an independent community pharmacy

Abstract

ObjectivesA pilot study was conducted to identify whether an opioid education and naloxone distribution (OEND) service affected (1) willingness to accept naloxone; (2) naloxone dispensation; and (3) patient knowledge about opioids, overdose symptoms, and naloxone in patients receiving buprenorphine prescriptions for opioid use disorder (OUD). MethodsParticipants were enrolled from January 2, 2019, to February 15, 2019, in this prospective noncontrolled study when receiving a buprenorphine prescription at the study site. The exclusion criteria included prescriptions being picked up by someone other than the patient and those who were below 18 years of age. The participants completed a written pre- and postsurvey containing “Yes” or “No,” “Select all that apply,” and open-ended questions assessing (1) willingness to accept naloxone and (2) change in opioid and naloxone knowledge. ResultsFifty-two participants were enrolled, and all completed the pre- and postsurveys. After the education, there was a not statistically significant change in the proportion of participants willing to accept naloxone from the pharmacy (28.8% vs. 36.5%; P = 0.31). In addition, there was an improvement in the proportion of participants believing that they need to carry naloxone with them (15.4% vs. 40.4%; P < 0.001). Naloxone dispensing increased 400% after the intervention implementation. Improvements in opioid knowledge also occurred. More participants correctly identified buprenorphine as an opioid (48.1% vs. 86.5%; P < 0.001), and correctly identified that methamphetamine (19.2% vs. 3.8%; P = 0.02) and cocaine (17.3% vs. 3.8%; P = 0.03) are not opioids. Of the 52 participants enrolled, 11.5% correctly identified all opioids on the presurvey, whereas 50% correctly identified all opioids on the postsurvey. ConclusionPatients diagnosed with OUD who are prescribed buprenorphine may be at high risk of an overdose if they return to use; yet, few OEND programs specifically target this population. This study suggests that OEND based in community pharmacies may be a strategy to increase naloxone access among these patients.