First Responder knowledge, perception and confidence in administering naloxone: Impact of a pharmacist-provided educational program in rural Mississippi

Published:April 14, 2019DOI:



      In July 2017, Mississippi passed House Bill 996, which permitted first responders to carry naloxone and required training before administration. There is no standard training offered in Mississippi for first responders. The purpose was to evaluate the change in first responder knowledge, perceptions, and confidence in administering naloxone after pharmacist training.


      The study was conducted at an independent community pharmacy in Holly Springs, Mississippi, with a longstanding presence in Marshall county. Participants included firefighters and law enforcement.

      Practice description

      Participants provided informed consent and attended a 1-hour training class taught by a pharmacist. Participants were recruited by telephone to the local police and fire chiefs, who agreed to have their departments trained by the pharmacy.

      Practice evaluation

      The survey consisted of 12 questions and covered topics including, knowledge and perception of the opioid crisis, overdose symptoms, reversal agents, and confidence to perform correct administration. The first outcome was change in participants’ knowledge of opioid overdose symptoms and was gathered with multiple choice questions. The second and third outcomes included change in perception and confidence in ability to administer reversal agents and were measured using a Likert-type scale ranging from strongly disagree to strongly agree. Fifty-seven participants completed the training, and the majority had more than 21 years of experience. The pre- and post-training survey responses demonstrated a statistically significant change in the first outcome where the average score of the knowledge assessment increased from 35% to 56% (P < 0.001). The perception and confidence outcomes had a statistically significant improvement in 5 of the 8 questions.


      Providing opioid education to law enforcement and firefighters increased their knowledge of overdose symptoms and improved administration technique, perception, and confidence to administer naloxone correctly.
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      Austin Crocker, PharmD, Clinical Pharmacist, G&M Pharmacy, Oxford, MS; at the time of study: PGY-1 Community Pharmacy Resident, University of Mississippi School of Pharmacy, University, MS, and Tyson Drugs, Holly Springs, MS


      Lauren Bloodworth, PharmD, BCPS, Clinical Associate Professor of Pharmacy Practice, University of Mississippi School of Pharmacy, University, MS


      Jordan Ballou, PharmD, BCACP, Clinical Assistant Professor of Pharmacy Practice, University of Mississippi School of Pharmacy, University of Mississippi, University, MS


      Anne Marie Liles PharmD, BCPS, Clinical Associate Professor of Pharmacy Practice, University of Mississippi School of Pharmacy, University, MS


      Laurie Fleming, PharmD, BC-ADM, BCACP, Clinical Associate Professor, Director of Experiential Programs and Experiential Affairs, University of Mississippi School of Pharmacy, University of Mississippi, Jackson, MS