244785 Collaborative Pharmacy Practice Agreements: A novel approach to expand naloxone access to reduce opioid overdose death

Monday, October 31, 2011

Traci Green, PhD , General Internal Medicine, Brown University/Rhode Island Hospital, Providence, RI
Sarah Bowman, MPH , Rhode Island Hospital, Providence, RI
Mike Yokell , The Miriam Hospital, Providence, RI
Michelle McKenzie, MPH , Infectious Disease/Immunology, The Miriam Hospital/Brown Medical School, Providence, RI
Nick Roder-Hanna, RPh , College of Pharmacy, University of Rhode Island, Kingston, RI
Nickolas Zaller, PhD , Medicine/Infectious Disease, Miriam Hospital, Providence, RI
Josiah Rich, MD, MPH , Medicine and Community Health, Brown Medical School, Providence, RI
Nationally, drug poisonings are the second leading cause of accidental death among adults and the leading cause of adult accidental death in Rhode Island (RI) and 15 other states. Drug-related deaths claimed the lives of 193 Rhode Islanders in 2008—nearly 4 people each week. Accidental drug intoxications -overdoses- comprise the vast majority of these poisonings, and opioids are the most common drugs involved in overdose death. Distribution of naloxone, an opiate antagonist capable of reversing overdose, to lay persons and opiate users has been demonstrated to be a feasible and effective component of a comprehensive approach to lowering opiate-related mortality. However, access to naloxone is often limited by provider hesitance to prescribe for community use and by limited funding for community-based programs to scale-up small naloxone programs. Pharmacies are an under-utilized component of the health care system, with highly-trained health care professionals who are very skilled at patient counseling. The use of Collaborative Pharmacy Practice Agreements (CPAs) between a prescriber and CPA-certified pharmacists may provide opportunities for medical providers and pharmacists to work together to increase access to naloxone in their community for prescription and illicit opioid users. A CPA was drafted in RI in a collaborative effort with the RI pharmacy board. CPA pilot implementation will provide coordinated service provision between a single prescriber, and a number of pharmacists at a single pharmacy increasing access to naloxone, and naloxone refills, in the community. The rationale, methods, CPA content, implementation, and status of the CPA pilot will be presented.

Learning Areas:
Clinical medicine applied in public health
Public health or related research

Learning Objectives:
• Describe the pros and cons of expanding Naloxone access through Collaborative Pharmacy Practice Agreements (CPAs) between medical providers and pharmacists • Analyze the success of rolling out a CPA for naloxone prescription in Rhode Island • Discuss the potential public health implications of increasing access to naloxone

Keywords: Drug Abuse, Pharmacists

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an epidemiologist with 6 years experience researching risk factors and prevention interventions for opioid overdose
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.