Investigating Community Pharmacy Take Home Naloxone Dispensing during COVID-19: The Impact of One Public Health Crisis on Another

Abstract

A recent report found that the number of opioid-related deaths in Ontario in the first 15 weeks of the COVID-19 pandemic was 38.2% higher than in the 15 weeks before the pandemic. Our study sought to determine if pharmacy professionals self-reported an increase or decrease in naloxone provision due to the pandemic and to identify adjustments made by pharmacy professionals to dispense naloxone during the pandemic. A total of 231 Ontario community pharmacy professionals completed an online survey. Pharmacy professionals’ barriers, facilitators, and comfort level with dispensing naloxone before and during the pandemic were identified. The sample consisted of mostly pharmacists (99.1%). Over half (51.1%) reported no change in naloxone dispensing, while 22.9% of respondents reported an increase and 24.7% a decrease. The most common adjustments made during the pandemic were training patients how to administer naloxone over video or phone, delivering naloxone kits, and pharmacy technicians offering naloxone at prescription intake. Over half (55%) of participants said the top barrier for dispensing was that patients did not request naloxone. Naloxone distribution through pharmacies could be further optimized to address the increased incidence of overdose deaths during the pandemic. Future research should investigate the reasons for changes in naloxone dispensing.

Protocol for the Optimizing Naloxone Dispensing in Pharmacies (ONDP) Online Continuing Education Program: A Randomized Controlled Trial

“…When a naloxone kit is dispensed, a study examining pharmacy dispensing data found that the most common reason for dispensing naloxone was the patient's request, and 89.5% of patients indicated that it was their first naloxone kit [26]. A survey examining the dispensing habits of pharmacists during the COVID-19 pandemic found that one of the main barriers for not dispensing naloxone during the pandemic was the lack of patients asking for a naloxone kit [30]. The survey also found that the pharmacists that were proactively offering kits and making adaptations to offer naloxone kits were doing so over the phone or by delivery, to work around less face-to-face interactions between the pharmacists and patients during the COVID-19 pandemic [30].…”

“…A survey examining the dispensing habits of pharmacists during the COVID-19 pandemic found that one of the main barriers for not dispensing naloxone during the pandemic was the lack of patients asking for a naloxone kit [30]. The survey also found that the pharmacists that were proactively offering kits and making adaptations to offer naloxone kits were doing so over the phone or by delivery, to work around less face-to-face interactions between the pharmacists and patients during the COVID-19 pandemic [30]. Therefore, although many patients are not benefiting from the THN program and many pharmacists are not proactively offering naloxone, there is a need for increased and equitable naloxone distribution through community pharmacy THN programs and there are new and innovative approaches to better THN dispensing.…”

“…This module will provide pharmacists with the tools needed to answer FAQs from patients and colleagues and correct any inaccurate perceptions pharmacists may have about naloxone. Module 3 will be built based on a survey of Ontario pharmacists and pharmacy technicians on their habits of offering naloxone during the COVID-19 pandemic and how these adaptations can be used going forward to overcome barriers to naloxone access [30]. The survey determined how naloxone dispensing patterns have changed since the start of the COVID-19 pandemic in comparison to before the pandemic started [30].…”

“…Module 3 will be built based on a survey of Ontario pharmacists and pharmacy technicians on their habits of offering naloxone during the COVID-19 pandemic and how these adaptations can be used going forward to overcome barriers to naloxone access [30]. The survey determined how naloxone dispensing patterns have changed since the start of the COVID-19 pandemic in comparison to before the pandemic started [30]. The survey also gathered what adaptations pharmacists have made to dispense naloxone kits now that most people are staying at home and what barriers and facilitators exist for dispensing naloxone during the pandemic [30].…”

“…The survey determined how naloxone dispensing patterns have changed since the start of the COVID-19 pandemic in comparison to before the pandemic started [30]. The survey also gathered what adaptations pharmacists have made to dispense naloxone kits now that most people are staying at home and what barriers and facilitators exist for dispensing naloxone during the pandemic [30]. The results from the survey were used to create a module that optimizes naloxone dispensing with COVID-19 restrictions in mind and overcomes barriers for naloxone dispensing that have been created because of the COVID-19 pandemic.…”