In one week, Lawlor Pharmacy was able to distribute more naloxone kits than it did during all of the previous year.
How? By using a digital tool that reaches out to patients to raise awareness and facilitate distribution of the harm-reduction drug.
“We texted patients that had received opioids in the last three months,” said Kyro Maseh, owner of Lawlor Pharmacy, at the Canadian Foundation for Pharmacy’s Pharmacy Forum event on April 3rd. Those who wanted a naloxone kit responded to the text with a simple ‘yes’ and the app followed up to schedule an appointment for distribution and training with a pharmacist. “It was very automated, very seamless…and required no effort on our part.”
The app is available through Box Labs, a provider of cloud-based pharmacy management tools. Co-founder Michael Demian is a pharmacy owner and this offering—called PLAAN, or Pharmacy Leaders Advancing the Availability of Naloxone—is close to his heart.
“Most of my experience in the pharmacy space has been in opioid-heavy pharmacies. Patients of mine have passed away…just because naloxone wasn’t readily available,” Demian shared at the webinar.
While researching the need for this PLAAN tool, Demian learned that only about five per cent of opioid users have access to naloxone. “Our goal with this is really simple, to increase the distribution nationally of naloxone by making it more accessible at the pharmacy level.”
In addition to identifying and texting patients who would benefit from a naloxone kit and scheduling those who opt in, the PLAAN tool advises the pharmacy when patient will be in, completes the required documentation and takes care of billing the public drug plan. Launched in January of this year, 104 pharmacies have enrolled so far. By the end of March, they had sent more than 4,400 texts and dispensed 1,735 naloxone kits, compared to fewer than 500 kits dispensed during the previous three months. Put another way, before implementing PLAAN, just 0.1 per cent of patients who should have had a naloxone kit did have one; after three months, that had increased to 28 per cent. “That’s quite a significant increase,” said Demian.
Maseh noted that so far no one has complained about receiving the text message, which can be customized by the pharmacy. As well, “some of the people who opted in surprised me,” he said. “A lot of them were younger. One said that the text was sent to his mother. He was going to a bachelor party in a few weeks and wanted a naloxone kit as well to keep on hand.”
With that in mind, Maseh said that a next step will be to use the PLAAN tool to message all his patients over the age of 18, not just those with a prescription for an opioid.
Jen Belcher, Vice-President, Strategic Initiatives and Member Relations, Ontario Pharmacists Association (OPA) and a practicing community and hospital pharmacist, also spoke at the Pharmacy Forum webinar. OPA is an investor in Box Labs.
She described naloxone distribution as an “exceptionally important…but not yet fully utilized” service in community pharmacies. “We need to look at the different ways in which we can make the operationalization of these types of services easier, more efficient and more consistent. To be able to provide that greater reach is truly critical at this juncture in our practice.”
Pharmacy’s role is not only to improve access to naloxone, but also to raise awareness and combat stigma. “This is an opportunity for pharmacists and all members of the pharmacy team to normalize the dispensing of naloxone kits,” she said, adding that their value has been proven by research. One study found that in areas where take-home naloxone programs are in effect, fatalities caused by opioid-induced overdose declined six-fold.
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