Home > The uptake of the pharmacy-dispensed naloxone kit program in Ontario: a population-based study.

Choremis, Beatrice and Campbell, Tonya and Tadrous, Mina and Martins, Diana and Antoniou, Tony and Gomes, Tara . (2019) The uptake of the pharmacy-dispensed naloxone kit program in Ontario: a population-based study. PLoS ONE, 14 (10) https://doi.org/10.1371/journal.pone.0223589

URL: https://journals.plos.org/plosone/article?id=10.13...

BACKGROUND: Naloxone is a life-saving antidote for opioid overdoses. In June 2016, the Ontario government implemented the Ontario Naloxone Program for Pharmacies (ONPP) to enhance access to naloxone.

OBJECTIVE: We examined the initial uptake of naloxone through the ONPP and characteristics of the individuals receiving and pharmacies dispensing naloxone kits.

METHODS: We conducted a population-based study of all Ontario residents who received a naloxone kit between July 1, 2016 and March 31, 2018. This involved 1) a cross-sectional analysis of monthly rates of kits dispensed; and 2) a descriptive analysis of all individuals and pharmacies who accessed and dispensed naloxone, respectively. We stratified individuals according to their opioid exposure as: prescription opioid agonist therapy (OAT) recipients, prescription opioid recipients, those with past opioid exposure and those with no/unknown opioid exposure. We calculated a Lorenz curve comparing the cumulative percent of naloxone-dispensing pharmacies and cumulative percent of naloxone kits dispensed and the corresponding Gini coefficient.

RESULTS: Naloxone dispensing through the ONPP increased considerably from 1.9 to 54.3 kits per 100,000 residents over the study period. In this time, 2,729 community pharmacies dispensed 91,069 kits to 67,910 unique individuals. Uptake was highest among prescription OAT recipients (40.7% of OAT recipients dispensed at least one kit), compared with 1.6% of prescription opioid recipients, 1.0% of those with past opioid exposure and 0.3% with no/unknown opioid exposure. Naloxone dispensing was highly clustered among pharmacies (Gini = 0.78), with 55.6% of Ontario pharmacies dispensing naloxone, and one-third (33.7%) of kits dispensed by the top 1.0% of naloxone-dispensing pharmacies.

CONCLUSION: The ONPP launch led to a rapid increase in the number of naloxone kits dispensed in Ontario. Although the program successfully engaged people prescribed OAT, efforts to increase uptake among others at risk of opioid overdose appear warranted. Opportunities for expanding pharmacy participation should be identified and pursued.


Item Type:Evidence resource
Drug Type:Opioid
Intervention Type:AOD disorder, AOD disorder drug therapy, AOD disorder treatment method, AOD disorder harm reduction
Date:October 2019
Page Range:e0223589
Volume:14
Number:10
EndNote:View
Subjects:B Substances > Opioids (opiates) > Opioid product > Naloxone
G Health and disease > Substance use disorder > Drug use > Drug intoxication > Poisoning (overdose)
J Health care, prevention and rehabilitation > Substance use prevention > Substance use harm reduction
T Demographic characteristics > Pharmacist
VA Geographic area > Canada

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