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

Abstract

Objectives The objective of this study is to assess West Virginia (WV) pharmacists’ stocking and dispensing practices of opioid-related medications and to identify the educational needs relating to providing naloxone in community pharmacies. Design A cross-sectional, anonymous, 49-item survey was created and validated to assess the educational needs of WV community pharmacists. Setting and participants The data collection instrument was administered to 266 pharmacists currently licensed in WV at six continuing education events throughout the state from March 1st, 2016 to June 15th, 2016. Outcome measures Pharmacists’ educational needs were determined using the Extended Parallel Process Model, which has four main constructs: perceived severity, perceived susceptibility, response efficacy, and self-efficacy. Pharmacists’ stocking and dispensing of opioids and related medications were also assessed. Results 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 over-the-counter. As for the other opioid-related medications, only 53.3% stocked buprenorphine and 74.8% stocked buprenorphine/naloxone. Conclusion As the most accessible health care providers, community pharmacists are acutely aware of how the opioid epidemic affects their communities. Some pharmacists in WV 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 from patients with opioid use disorder. Furthermore, pharmacists in WV 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.

Indiana community pharmacist preceptors’ knowledge and perceptions of medication-assisted treatment

“…21 In the second study, researchers assessed West Virginia community-based pharmacy practices regarding buprenorphine product stocking and dispensing. 22 There are still limited data evaluating U.S. community-based pharmacists' knowledge and perceptions regarding MAT. Investigating this population may yield beneficial data to enhance MAT access for patients with OUD.…”

“…As this U.S. study's population can only dispense buprenorphine products for MAT, these results are similar. In the United States, though Thornton et al 22 did not address perceptions specifically, respondents estimated that a mean of 23.6 (26.8 standard deviation) patients out of 100 filling buprenorphine prescriptions misused or abused the medication. 22 This similarity, internationally and in the United States, describes a common concern and a potentially negative perception held by communitybased pharmacists when providing care to patients with OUD-specifically that the patients will misuse buprenorphine products.…”

“…In the United States, though Thornton et al 22 did not address perceptions specifically, respondents estimated that a mean of 23.6 (26.8 standard deviation) patients out of 100 filling buprenorphine prescriptions misused or abused the medication. 22 This similarity, internationally and in the United States, describes a common concern and a potentially negative perception held by communitybased pharmacists when providing care to patients with OUD-specifically that the patients will misuse buprenorphine products. In the study by Matheson et al, 15 community-based pharmacy managers have demonstrated a link between attitude and provision of services to patients with addiction, including dispensing methadone, which suggests that if pharmacists continue to believe patients may divert and misuse medications for MAT, they will hesitate to dispense MAT even for patients with legitimate medical need.…”

Pharmacists and the opioid crisis: A narrative review of pharmacists' practice roles

“…Research has shown that pharmacists can effectively engage patients with OUD to improve their outcomes . In turn, patients have reported positive attitudes when a pharmacist was included in their OUD treatment care …”

“…22,23 In turn, patients have reported positive attitudes when a pharmacist was included in their OUD treatment care. 24,25 We conducted a narrative literature review to highlight several pharmacist-driven practices that provide a broad range of prevention, harm reduction, treatment, and recovery services to patients affected or potentially affected by the opioid crisis.…”