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

Published:April 14, 2019DOI:https://doi.org/10.1016/j.japh.2019.04.011

      Abstract

      Objective

      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.

      Setting

      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.

      Conclusion

      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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      References

        • Dart R.C.
        • Surratt H.L.
        • Cicero T.J.
        • et al.
        Trends in opioid analgesic abuse and mortality in the United States.
        N Engl J Med. 2015; 372: 241-248
        • Bicket M.C.
        Unused prescription opioids after surgery. JAMA Intern Med. 2017.
        (Available at:)
      1. Guy GP Jr, Zhang K, Bohm MK, et al. Vital signs: changes in opioid prescribing in the United States, 2006-2015. Available at: https://www.cdc.gov/mmwr/volumes/66/wr/mm6626a4.htm. Accessed May 23, 2018.

        • Centers for Disease Control and Prevention
        Opioid overdose.
        (Available at:)
        • National Institute on Drug Abuse
        Overdose death rates.
        (Available at:)
        • Network for Public Health Law
        Legal interventions to reduce overdose mortality: naloxone access and overdose good Samaritan laws.
        (Available at:)
      2. H.B. 996. 2017 Regular Session. (Mississippi 2017).

        • Smyser P.A.
        • Lubin J.S.
        Surveying the opinions of Pennsylvania Chiefs of Police toward officers carrying and administering naloxone.
        Am J Drug Alcohol Abuse. 2018; 44: 244-251
        • North Carolina Harm Reduction Coalition
        Law Enforcement Departments Carrying Naloxone. Raleigh, NC: NCHRC. 2016.
        (Available at:)
        • Kaleo Inc
        Evzio Website. 2017.
        (Available at:)
      3. Narcan Website.
        (Available at:)
        • Mississippi Board of Pharmacy, Mississippi Bureau of Narcotics, Mississippi State Department of Health, Mississippi Department of Mental Health
        The Mississippi Opioid and Heroin Data Collaborative.
        (Available at:)
        • Simmons J.
        • Rajan S.
        • Goldsamt L.
        • Elliott L.
        Implementation of online opioid overdose prevention, recognition and response trainings for professional first responders: year 1 survey results.
        Drug Alcohol Depend. 2016; 169: 1-4
        • Ray B.
        • O’Donnell D.
        • Kahre K.
        Police officer attitudes towards intranasal naloxone training.
        Drug Alcohol Depend. 2015; 146: 107-110

      Biography

      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

      Biography

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

      Biography

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

      Biography

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

      Biography

      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