UNT System College of Pharmacy, 3500 Camp Bowie Blvd, Fort Worth, TX 76107, USA.
University of Houston College of Pharmacy, 4849 Calhoun Road, Room 3044, Houston, TX 77204, USA.
Res Social Adm Pharm. 2019 Aug;15(8):992-999. doi: 10.1016/j.sapharm.2018.10.027. Epub 2018 Oct 28.
Opioid misuse causes over 50,000 deaths in America each year. Prescription drug monitoring program (PDMP) databases serve as a useful decision analysis tool in managing patients with known or potential opioid use disorder (OUD). To date, however, little research has sought to determine how pharmacists use PDMPs to engage patients with potential OUD.
To elicit modal salient beliefs of community pharmacists regarding their willingness to engage patients (i.e., provide interventional counseling) with suspected controlled substance misuse as identified from reviewing PDMP data.
Focus groups were conducted among Texas community pharmacists using the theory of planned behavior as a theoretical framework. Open-ended questions were used to capture behavioral beliefs, normative beliefs and control beliefs associated with pharmacists' engagement. Qualitative analysis using ATLAS.ti software was conducted to identify modal salient beliefs elicited by at least 20% of the study sample.
A total of 31 community pharmacists participated. Fifteen behavioral beliefs, thirteen normative beliefs and eleven control beliefs were identified as modal salient beliefs. The most prevalent behavioral belief was the disadvantage associated with patient confrontations. Pharmacists also believed that engaging patients may cause loss of customers/business but may help patients receive appropriate counseling. When asked about their normative beliefs, pharmacists identified regulatory agencies (e.g., pharmacy boards, law enforcement) and family/friends of patients as groups of individuals who influence their willingness to refer. Time required for counseling was found to be the most commonly cited control belief.
The results illustrate some of the challenges faced by community pharmacists when considering engagement of patients with misuse of prescription opioids. Addressing these barriers to patient engagement is critical to increasing pharmacists' willingness to engage patients with potential OUD.
阿片类药物滥用每年导致美国超过 5 万人死亡。处方药物监测计划 (PDMP) 数据库是管理已知或潜在阿片类药物使用障碍 (OUD) 患者的有用决策分析工具。然而，迄今为止，几乎没有研究试图确定药剂师如何使用 PDMP 来接触有潜在 OUD 的患者。
从 PDMP 数据中确定有疑似受控物质滥用的患者，并引出社区药剂师对与他们接触（即提供干预性咨询）的意愿的主要显著信念。
使用计划行为理论作为理论框架，在德克萨斯州的社区药剂师中进行焦点小组。使用开放式问题来捕获与药剂师参与相关的行为信念、规范信念和控制信念。使用 ATLAS.ti 软件进行定性分析，以确定至少有 20%的研究样本引出的主要显著信念。
共有 31 名社区药剂师参与。确定了 15 种行为信念、13 种规范信念和 11 种控制信念作为主要显著信念。最普遍的行为信念是与患者对抗相关的劣势。药剂师还认为，与患者接触可能会导致失去顾客/业务，但可能会帮助患者获得适当的咨询。当被问及他们的规范信念时，药剂师确定了监管机构（如药房委员会、执法部门）和患者的家人/朋友是影响他们转介意愿的群体。咨询所需的时间被认为是最常被引用的控制信念。
结果说明了社区药剂师在考虑接触滥用处方阿片类药物的患者时面临的一些挑战。解决这些接触患者的障碍对于提高药剂师接触潜在 OUD 患者的意愿至关重要。
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