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Pharmacists' readiness to provide naloxone in community pharmacies in West Virginia.

ABSTRACT: The objective of this study is to assess West Virginia pharmacists' stocking and dispensing practices of opioid-related medications and to identify the educational needs relating to providing naloxone in community pharmacies.A cross-sectional, anonymous, 49-item survey was created and validated to assess the educational needs of West Virginia community pharmacists.West Virginia.The data collection instrument was administered to 266 pharmacists currently licensed in West Virginia at 6 continuing pharmacy education events throughout the state from March 1 to June 15, 2016.Pharmacists' educational needs were determined using the Extended Parallel Process Model, which has 4 main constructs: perceived severity, perceived susceptibility, response efficacy, and self-efficacy. Pharmacists' stocking and dispensing of opioids and related medications were also assessed.Pharmacists completed 157 surveys. They were mostly male (56.1%), full-time employees (67.5%), worked mostly in community pharmacies (69.4%), and had a mean age of 50.19 years (SD = 13.62). The newly adapted opioid perceived efficacy and perceived severity of opioid adverse events scales were tested for reliability and validity. Only 20.4% of the community pharmacists surveyed felt comfortable selling naloxone without a prescription. As for the other opioid-related medications, only 53.3% stocked buprenorphine and 74.8% stocked buprenorphine/naloxone.As the most accessible health care providers, community pharmacists are acutely aware of how the opioid epidemic affects their communities. Some pharmacists in West Virginia are hesitant to stock and dispense opioids and opioid-dependence medications. Although this may decrease the flow of potentially abused drugs into the community, it may also restrict access to necessary therapy for patients with opioid use disorder. Furthermore, pharmacists in West Virginia are not yet comfortable stocking and dispensing naloxone. Tailored educational materials can help in controlling the pharmacists' fear and reinforce the benefits of over-the-counter naloxone use.

SUBMITTER: Thornton JD

PROVIDER: S-EPMC5352525 | biostudies-literature | 2017 Mar - Apr

REPOSITORIES: biostudies-literature

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Pharmacists' readiness to provide naloxone in community pharmacies in West Virginia.

Thornton J Douglas JD Lyvers Elizabeth E Scott Virginia Ginger G VGG Dwibedi Nilanjana N

Journal of the American Pharmacists Association : JAPhA 20170202 2S

<h4>Objectives</h4>The objective of this study is to assess West Virginia pharmacists' stocking and dispensing practices of opioid-related medications and to identify the educational needs relating to providing naloxone in community pharmacies.<h4>Design</h4>A cross-sectional, anonymous, 49-item survey was created and validated to assess the educational needs of West Virginia community pharmacists.<h4>Setting</h4>West Virginia.<h4>Participants</h4>The data collection instrument was administered ...[more]

PMID: 28163027

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Project description:ObjectivesTo examine the availability of naloxone in community pharmacies and examine differences in naloxone availability across pharmacy location, pharmacy type, and areas of greater opioid overdose mortality.MethodsA cross-sectional design was used to conduct a telephone survey of community pharmacists. A list of community pharmacies was obtained from the Georgia Board of Pharmacy; 25% were randomly selected, stratified across the National Center for Health Statistics rural-urban codes. The primary outcome was pharmacist-reported naloxone stock status. Predictor variables included urban and rural location, pharmacy type, and opioid related mortality rates. Descriptive statistics and multivariable logistic regression were performed using StataCorp. 2017 Stata Statistical Software: Release 15.ResultsOf the 600 pharmacies randomly selected, 166 pharmacies were not called because they were not open to the public or had known corporate policy prohibiting the release of stock information, or because of undisclosed reasons. Of the 434 called, 330 (76%) answered and agreed to participate and were included in the analysis. The majority were metropolitan (66%) and chain pharmacies with 4 or more locations (62%). Only 31% reported that naloxone was available for same-day purchase, 65% did not carry naloxone and 3% indicated that it was out of stock. Chain community pharmacies (CVS, Walgreens, etc.), were more likely than independent pharmacies to have naloxone for same-day purchase (45% vs 24%; OR = 2.106, 95% CI 1.124-3.943), and areas with high opioid mortality rates were more likely to have naloxone than areas with low mortality rates (38% vs. 24%; odds ratio 1.866 [95% CI 1.059-3.290]).ConclusionPatients in Georgia face barriers accessing the potentially life-saving medication naloxone. Most community pharmacies (69%) did not have naloxone stocked. Naloxone was less likely to be available from independent pharmacies and in areas of lower than average opioid mortality rates. Additional strategies are needed to increase access to naloxone in an effort to combat the opioid epidemic.

Project description:BackgroundWe report on efforts to measure readiness to adopt opioid safety initiatives in community pharmacies within 2 large chains. Previous studies identified lack of knowledge, confidence, or enthusiasm in addressing harm reduction efforts. We implemented an intervention that provided training to improve opioid safety. The goal was to increase naloxone prescribing and nonprescription syringe sales, reduce stigma, and decrease opioid overdoses among patients and customers.ObjectivesTo assess pharmacy readiness for intervention delivery, by characterizing pharmacy culture around opioid safety; describing current practices and challenges interacting with patients and customers on naloxone, nonprescription syringe sales, and buprenorphine; and determining pharmacy defined goals for implementing the intervention.MethodsThe sample included pharmacy managers and staff pharmacists from 2 large chains who completed a brief phone interview. Interviews consisted of Likert-scale and open-ended, theoretically driven questions. Questions focused on workplace culture, patient engagement, naloxone and buprenorphine prescribing, nonprescription syringe sales, and intervention goals. Coding categories for the open-ended questions were derived using a thematic review of responses.ResultsA total of 163 respondents described both workplace culture and how they encourage patient opioid safety as including public health awareness, patient engagement, and naloxone prescribing. Sale of nonprescription syringes exhibited high variability: no sales barriers (53.9%), sales with barriers (21.5%), and no sales (20.9%). Half of pharmacists (50.3%) interacted with buprenorphine prescribers outside of medication fills. Most respondents (68.7%) endorsed being ready to promote the intervention. Pharmacists named goals in adopting the intervention of wanting more knowledge and educational materials, talking points with patients, and best practices for offering naloxone.ConclusionCommunity pharmacists, before implementation, described awareness of and receptiveness to opioid safety initiatives, with substantial barriers around nonprescription syringe sales. Assessed knowledge level, culture, and identified barriers that emerged in the readiness assessments can be used to tailor future pharmacy-specific programming.

Project description:BackgroundReports of regulatory and evidentiary gaps have raised concerns about the marketing and use of natural health products (NHPs). The majority of NHPs offered for sale are purchased at a community pharmacy and pharmacists are "front-line" health professionals involved in the marketing and provision of NHPs. To date, the involvement of pharmacists in pharmacy care involving NHPs and the degree to which concerns over the safety, efficacy, marketing and regulation of NHPs are addressed in pharmacy care in Canada have not been studied.MethodsUsing Qualtrics, a web-based data collection and analysis software, and a study instrument made up of fifteen (15) open-ended, closed and rating scale questions, we surveyed the attitudes and practices of 403 community pharmacists in the Canadian province of Alberta regarding NHPs offered for sale in community pharmacies.ResultsThe majority of pharmacists surveyed (276; 68%) recommend NHPs to clients sometimes to very often. Vitamin D, calcium, multivitamins, prenatal vitamins, probiotics and fish oil and omega-3 fatty acids were the most frequently recommended NHPs. The most common indications for which NHPs are recommended include bone and musculoskeletal disorders, maintenance of general health, gastrointestinal disorders and pregnancy. Review articles published in the Pharmacist's Letter and Canadian Pharmacists Journal were the primary basis for recommending NHPs. The majority of pharmacists surveyed (339; 84%) recommend the use of NHPs concurrently with conventional drugs, while a significant number and proportion (125; 31%) recommend alternative use. Pharmacists in the study overwhelmingly reported providing counselling on NHPs to clients based on information obtained mainly from the Natural Medicines Comprehensive Database.ConclusionsThe study findings indicate a high prevalence of pharmacy care relating to NHPs among study participants. Although pharmacists' practices around NHPs are consistent with the existing licensing framework, we found some involvement in problematic practices that necessitate further research and potential policy scrutiny. The study also uncovered patterns of recommendations, including sources relied on in recommending NHPs and in providing counselling to patients, that raise concerns about the quality and credibility of NHP-related care provided to pharmacy patrons.

Project description:OBJECTIVES:The objectives of this study were (1) to assess pharmacist readiness to provide pharmaceutical care for transgender patients through measuring both pharmacists' knowledge and attitudes towards transgender patients, (2) to assess transgender patients' perception of pharmacist readiness to provide them pharmaceutical care through measuring both pharmacists' knowledge and attitudes toward them, and (3) to compare pharmacist readiness to provide pharmaceutical care for transgender patients and patient perception of this readiness. DESIGN:The study used a descriptive, cross-sectional design. The pharmacist's readiness and the transgender patient's perception of their readiness, defined as a combination of knowledge and attitude, were evaluated. Two separate, validated questionnaires with dichotomous, multiple choice, and open-ended questions were used to measure both constructs among both populations. SETTING:Community-based research. PARTICIPANTS:Pharmacists practicing in Puerto Rico were provided the questionnaire by e-mail or in person. Transgender participants in Puerto Rico were recruited through health clinics and community partners and were surveyed in person. The analysis included responses from 96 pharmacists and 31 transgender participants. RESULTS:The majority of the pharmacists' knowledge scores (90%) were found in the low (0-5) and moderate (6-10) ranges, with a mean score of 7.23 out of a total possible score of 16 (SD ±2.36). For the attitude construct, most of the scores (81%) were found in the high (18-26) range, with a mean score of 19.63 out of a total possible score of 26 (SD ±3.65). For both constructs, transgender patient perceptions echoed the results of the pharmacists, indicating several perceived knowledge deficits in combination with mostly positive attitudes. CONCLUSION:The majority of pharmacists demonstrated positive attitudes toward caring for transgender patients, and transgender patients also perceived these positive attitudes from pharmacists. However, the measured and perceived knowledge deficits observed in this study suggest the need for educational interventions to improve pharmacist readiness to provide care for transgender patients.

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Pharmacists' readiness to provide naloxone in community pharmacies in West Virginia.

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Pharmacists' readiness to provide naloxone in community pharmacies in West Virginia.

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