Barriers and facilitators to community pharmacist-provided injectable naltrexone for formerly incarcerated individuals during community reentry

IF 1.8 Q3 PHARMACOLOGY & PHARMACY
Jason S. Chladek , Michelle A. Chui
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Abstract

Introduction

Medications for opioid use disorder (MOUD), including injectable naltrexone, are a key component in the treatment of opioid use disorder (OUD). These medications are especially important for individuals transitioning out of correctional facilities and back into their communities. Unfortunately, few formerly incarcerated individuals have access to MOUD upon reentry, incurring a 40-fold greater likelihood of overdose following release compared to the general population. In Wisconsin, community pharmacists have the authority to administer naltrexone injections. However, they have not been explored as a resource for improving access to this medication for this patient population.

Objective

As a first step, the goal of this study was to understand the barriers and facilitators impacting the use of community pharmacist-provided injectable naltrexone by formerly incarcerated individuals during community reentry period.

Materials and methods

The researcher conducted semi-structured interviews with 18 individuals representing five stakeholder groups, including four MOUD prescribers, three community pharmacists, four correctional staff, four community organization or non-profit staff, and three individuals or family members/caregivers of individuals with a history of OUD and incarceration. Deductive and inductive content analysis were used to identify barrier and facilitator categories across the five levels of the Socioecological Model.

Results

Overall, participants discussed factors at every level, and many barriers and facilitators confirmed findings from existing literature focused on MOUD access for formerly incarcerated individuals. Participants also identified factors more specific to community pharmacies, including 1) lack of interagency collaboration between pharmacists, prescribers, and correctional facilities and 2) lack of awareness of community pharmacist-provided injectable naltrexone services.

Conclusions

Future research should explore interventions to address the barriers identified in this study and improve connections between community pharmacists and formerly incarcerated individuals. This work can help ensure that these individuals are given the chance to successfully reintegrate into their communities.
社区药剂师在重新进入社区期间为以前被监禁的人提供注射纳曲酮的障碍和促进因素。
阿片类药物使用障碍(mod)的药物,包括注射纳曲酮,是治疗阿片类药物使用障碍(OUD)的关键组成部分。这些药物对于从惩教设施过渡到社区的个人尤其重要。不幸的是,很少有以前被监禁的人在重返监狱后能够使用mod,与普通人群相比,释放后过量服用的可能性要高40倍。在威斯康星州,社区药剂师有权进行纳曲酮注射。然而,他们还没有被探索作为一种资源,以改善获得这种药物的患者群体。目的:作为第一步,本研究的目的是了解影响社区药剂师提供的可注射纳曲酮的障碍和促进因素,以前被监禁的人在社区重新进入期间使用。材料和方法:研究人员对代表5个利益相关者群体的18个人进行了半结构化访谈,包括4名OUD处方者,3名社区药剂师,4名惩教人员,4名社区组织或非营利人员,以及3名有OUD病史和监禁的个人或家庭成员/照顾者。采用演绎和归纳的内容分析方法,在社会生态模型的五个层次上识别障碍和促进因素类别。结果:总体而言,参与者讨论了各个层面的因素,许多障碍和促进者证实了现有文献中关于前监禁人员访问mod的发现。参与者还确定了社区药房特有的因素,包括1)药剂师、开处方者和惩教机构之间缺乏机构间合作;2)缺乏对社区药剂师提供的注射纳曲酮服务的认识。结论:未来的研究应该探索干预措施,以解决本研究中确定的障碍,并改善社区药剂师和前监禁人员之间的联系。这项工作有助于确保这些人有机会成功地重新融入他们的社区。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
1.60
自引率
0.00%
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0
审稿时长
103 days
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