Community pharmacy harm reduction services for drug misusers: national service delivery and professional attitude development over a decade in Scotland

Matheson, Catriona; Bond, Christine; Tinelli, Michela

doi:10.1093/pubmed/fdm064

Cited by 55 publications

(61 citation statements)

References 12 publications

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“…Matheson et al looked at the change in pharmacists' attitudes toward providing harm reduction services and noted that with increased exposure to IDUs, pharmacists became more positive about working with this population. 22 This study also found that pharmacists were more comfortable providing opioid substitution services than needle exchange programs, as this role is more in line with a pharmacist's involvement in drug therapy. In a study looking at pharmacists' attitudes about providing advice to IDUs on preventing acquisition and transmission of HIV, hepatitis B and hepatitis C infections, pharmacists acknowledged the need for this service and expressed a desire to expand their role in this area.…”

Section: 31mentioning

confidence: 60%

“…In Scotland, pharmacists have been active in harm reduction by providing needle exchange services to IDUs, and the number of pharmacies and service users involved in these programs has been increasing. 22 Due to rising levels of hepatitis (B and C) and the recognition that pharmacies could be providing more harm reduction services, better payment models and more guidance on needle exchange policy have been introduced for pharmacies. This policy shift is likely one reason for the increased uptake of harm reduction services by pharmacies in Scotland.…”

Section: Current Practices In Harm Reductionmentioning

confidence: 99%

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Pharmacists and Harm Reduction: A Review of Current Practices and Attitudes

Watson

Hughes

2012

Can Pharm J

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Conclusion:As one of the most accessible health care providers, community pharmacists are in an ideal position to provide meaningful services to injection drug users. However, in order to do so, pharmacists require additional support in the form of better health team and system integration, as well as remuneration models. Can Pharm J 2012;145:124-127.e2. health promotion and traditionally refers to policies or programs that are aimed at decreasing the adverse health, social and economic consequences of high-risk behaviours such as drug and alcohol use. 4 For the purposes of this paper, harm reduction services refer to strategies aimed at minimizing the harmful consequences associated with injection drug use and high-risk sexual activity, which are 2 significant social and health issues. Injection drug use accounts for 17% of new cases of HIV infection and approximately two-thirds of new cases of hepatitis C in Canada. 5,6 While the economic burden related to injection drug use is difficult to determine, the lifetime cost of treating each case of HIV infection is $150,000 and it has been estimated that the cost of treating hepatitis C in injection drug users (IDUs) in Canada between 2006 and 2026 will be $3.96 billion. 7,8 With the sequelae of injection drug use and high-risk sexual activity being so costly and burdensome, the implementation of more effective programs aimed at reducing these problems is a priority.Throughout the literature, community pharmacists are acknowledged as important, underutilized resources in preventing the spread of HIV and other blood-borne infections. Pharmacists are recognized as one of the most accessible health care professionals for the general population and are in an ideal position to reach IDUs, who are often socially marginalized and often wish to maintain anonymity. Potential harm reduction roles for community pharmacists that have been identified include the sale of condoms and other safer-sex products, educating on safe-sex practices, selling clean needles/syringes, providing a site for disposal of used needles and syringes and dispensing oral methadone for the treatment of opiate dependence.The purpose of this paper is to provide an overview of pharmacists' involvement in harm reduction services, with a particular focus on research that has evaluated pharmacists' attitudes and barriers toward provision of these services. A review of the literature from 1995 to 2011 was conducted through MEDLINE, PubMed and Scopus using the search terms pharmacist, harm reduction, disease prevention, health promotion, attitudes, competence and barriers. Relevant references of articles identified by the search were also reviewed by both study investigators. To be included in this review, studies had to focus on harm reduction services involving pharmacies, pharmacists' attitudes and identified barriers toward providing such services or both. Articles were excluded if they were not in English or did not meet the above inclusion criteria. Results Current practices in harm reductionOne of t...

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Section: 31mentioning

confidence: 60%

Section: Current Practices In Harm Reductionmentioning

confidence: 99%

Pharmacists and Harm Reduction: A Review of Current Practices and Attitudes

Watson

Hughes

2012

Can Pharm J

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“…Against a background of increasing methadone users, 4 this indicates a considerably higher rate of methadone prescribing by specialist services since 2000.…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

“…In Scotland, the number of methadone users is increasing, 4 with a current estimate of 22 000 people prescribed methadone. 5 There are over 400 drug-related deaths annually.…”

Section: Introductionmentioning

confidence: 99%

Management of drug misuse: an 8-year follow-up survey of Scottish GPs

Matheson

Porteous²,

Teijlingen³

et al. 2010

Br J Gen Pract

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This study repeated a Scotland-wide survey of one-infour GPs from 2000, to compare findings with 2008. A 60% response was achieved (of 1065). Almost 44% of GPs were treating drug misusers (62% in 2000). Enhanced services were provided by less than half of practices. Seven per cent of responders were only comfortable prescribing below the recommended minimum dose of 60 mg methadone, (33% in 2000). Over 70% offered blood-borne virus screening and 71% were aware of patients using psychostimulants. Recent changes, particularly the new GP contract may have decreased GP involvement in treating drug misusers.

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“…Those not accessing naloxone through existing services may include pain patients using prescription opioids, in addition to those that choose to avoid services identified for people who use drugs due to concerns such as anonymity. In Scotland and England community pharmacy is already well integrated into the harm reduction provider network, with increasing engagement demonstrated over time (Matheson, Bond, & Tinelli, 2007;Sheridan, Manning, Ridge, Mayet, & Strang, 2007).…”

Section: Introductionmentioning

confidence: 99%