Barriers and Facilitators to Implementing a Naloxone Collaborative Drug Therapy Agreement: A Qualitative Study of Washington State Pharmacists

Abstract

Background: Opioid-involved overdose deaths have increased dramatically over the past decade, both nationally and in Washington State. A naloxone collaborative drug therapy agreement (CDTA) is an emerging community pharmacy-based strategy to expand access to take-home naloxone, the opioid overdose antidote. Methods: Semi-structured interviews were conducted with 13 community pharmacy managers and owners in Washington State's Puget Sound region to assess their knowledge, attitudes, and practices regarding a naloxone CDTA. Results: Although many pharmacists regularly encounter patients at risk of opioid overdose, few address this risk directly when providing patient education. Low awareness of take-home naloxone, discomfort with approaching patients about overdose, cost issues, and regulatory implications present as significant barriers to implementing a naloxone CDTA. Conclusions: Comprehensive implementation efforts are needed address a number of barriers to naloxone CDTA adoption and provide adequate education and support to pharmacists who may see a need for take-home naloxone in their patient populations.