Pharmacy support staff involvement in, and attitudes towards, pharmacy-based services for drug misusers

Abstract

Objective This study aimed to examine involvement of pharmacy support staff in delivering services to drug misusers; to quantify their participation in related training; and to examine relationships between attitudes, practice experience and training. Methods The setting was a random sample of 10% of UK community pharmacies (n = 1218) using a postal questionnaire with two reminders. Pharmacy managers were used as gate‐keepers to access pharmacy support staff, which included dispensary technicians and medicines counter assistants. Key findings Six hundred and ninety (56.7%) pharmacies responded, and 1976 completed questionnaires were returned from 610 (50.1%) pharmacies. A further 80 (6.6%) opted out. Three‐fifths of staff had no input into decisions about whether their pharmacy provided services for drug misusers. One‐third working in pharmacies that provide services were uncertain or negative about whether their pharmacy should do so. Staff were more involved in needle exchange (91%) and decisions to sell needles (95%) than supervising consumption of therapies (64%) or handing out dispensed medicines to drug misusers (73%), suggesting managers perceive needle exchange and sales as appropriate roles. Three‐quarters of those working in pharmacies that provide services had not received any training to do so. Those who had undertaken training and who worked in pharmacies that provided services had significantly more positive attitudes compared to those had not undertaken training but also worked in pharmacies that provided services, or those who had undertaken training but did not provide services. Conclusions Pharmacy support staff were involved extensively in drug‐misuse services but the majority had not been trained to do so. Attitudes were more positive in those who were involved in service provision and had undertaken training. The findings suggest a need for more extensive training and for further exploration of the views of managers on appropriate roles, particularly the clinical versus supply nature of needle exchange. This is timely given the recent publication of guidelines by the National Institute of Health and Clinical Excellence (NICE) on needle exchange.

Public health in community pharmacy: A systematic review of pharmacist and consumer views

“…Support staff in a survey in Scotland also reported similar concerns [ 30 ]. Only half of support staff (52.6%) in this study thought that their pharmacy should provide services to drug misusers [ 31 ]. The possibility of providing free injecting equipment to drug misusers was met with strong resistance in the study in Estonia.…”

Community pharmacist experiences of providing needle and syringe programmes in Ireland

“…1,[16][17][18][19][33][34] Pharmacist experiences illustrated the positive nature of providing needle exchange services In contrast, findings elsewhere have illustrated more negative views, where some pharmacists have disclosed negative attitudes towards PWID and although attitudes towards the provision of services in pharmacies for PWID have generally improved in recent years they are still mixed. [35][36][37] Recent systematic reviews have underscored the general positive attitude to providing harm reduction advice in pharmacies, with common barriers centring on lack of time and specific training, fear of attracting difficult service users, insufficient remuneration, and difficulties in communicating with adjunct health providers. 2 Of note for this pilot programme going forward, and building on the goodwill and positive attitude toward providing NSP, is that service user perceptions of negative staff attitudes and experiences of discrimination have been associated with increased risk of needle sharing activities 38 and the impact of needle and syringe exchange services on BBV infection may be greater where clients engage in other health interventions in addition to needle exchange.…”

“…2 Of note for this pilot programme going forward, and building on the goodwill and positive attitude toward providing NSP, is that service user perceptions of negative staff attitudes and experiences of discrimination have been associated with increased risk of needle sharing activities 38 and the impact of needle and syringe exchange services on BBV infection may be greater where clients engage in other health interventions in addition to needle exchange. 39 Equally, the attitudes of pharmacy staff towards service provision may improve with training 11,16,35 and with increased experience of providing services. 14 Where the needle exchange is a new service within the pharmacy, it might be expected that attitudes and relationships with clients improve with familiarity.…”

The caring behaviours of Danish pharmaconomists: insight for pharmacy technician practice around the world

“…As pharmacists assume more clinical roles, support personnel are increasingly involved in direct care and checking their own work . In the community setting, pharmacy technicians have been reported to be the ‘face’ of pharmacy, taking primary responsibility for relationships with clientele .…”

“…[17,18] As pharmacists assume more clinical roles, support personnel are increasingly involved in direct care and checking their own work. [19][20][21][22][23][24] In the community setting, pharmacy technicians have been reported to be the 'face' of pharmacy, taking primary responsibility for relationships with clientele. [25,26] These trends underscore shifts in practice to promote greater autonomy for workforce cadres to promote patient-centric practice, while gaining efficiency in operations, [27,28] and having been occurring in a number of countries and regions, including but not limited to the United Kingdom, New Zealand, Australia and the United States.…”