Identifying barriers and facilitators to providing enhanced naloxone education services in community pharmacies.

Publication/Presentation Date

1-1-2026

Abstract

BACKGROUND: Opioid misuse remains a critical public health issue in the United States, with approximately 80,000 opioid-related deaths reported in 2023. Community pharmacists are well-positioned to improve access to and education about naloxone. Despite the availability of naloxone through standing orders and over-the-counter options, barriers such as stigma, cost, and workflow limitations persist.

OBJECTIVES: This study aimed to identify barriers and facilitators to implementing and billing for reimbursable naloxone education services via a payer contract in community pharmacies.

METHODS: This implementation science study utilized a qualitative approach. Pennsylvania Pharmacists Care Network eCare plan submissions were analyzed using descriptive statistics. Pharmacies were included in a semi-structured interview if they submitted an eCare plan for the naloxone education service since January 2023. An interview guide was developed based on the RE-AIM framework, which evaluates service implementation across five domains: Reach, Effectiveness, Adoption, Implementation, and Maintenance. Interviews were recorded and transcribed via Zoom, then independently coded by 3 investigators in NVivo. A mixed deductive-inductive thematic analysis was conducted to identify barriers, facilitators, and sustainability themes related to program implementation.

RESULTS: Forty pharmacies submitted 653 eCare plans for the naloxone and education dispensing payer program for reimbursement. Twelve participated in semi-structured interviews, which represented 232 of the submitted eCare plans. Six themes emerged from the interviews, including building relationships with community members; expanding staff roles and empowering team collaboration in patient care to support and initiate patient services; consistent processes for identifying, educating, and billing; reducing stigma and increasing naloxone distribution through open communication and community engagement; common barriers to implementing naloxone education services; and the need for enhanced education and training resources to improve service efficiency.

CONCLUSION: Naloxone education by community pharmacists is important in preventing opioid-related adverse events. Providing pharmacists with educational resources and training may enhance their ability to effectively educate patients about naloxone.

Volume

66

Issue

1

First Page

102982

Last Page

102982

ISSN

1544-3450

Disciplines

Medicine and Health Sciences

PubMedID

41198028

Department(s)

Department of Pharmacy, Fellows and Residents

Document Type

Article

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