J Am Pharm Assoc (2003). 2023 Jan-Feb;63(1):336-342. doi: 10.1016/j.japh.2022.10.004. Epub 2022 Oct 14.
Community pharmacists are well-positioned to engage in opioid-related harm reduction activities (i.e., opioid interventions). However, several barriers to providing these interventions have been identified. Comparing the frequencies of opioid interventions and identifying which barriers are perceived to have the highest impact in providing interventions will yield valuable information for increasing opioid use disorder (OUD) care access within pharmacies.
To (1) characterize the frequency of 9 opioid interventions in community practice settings and (2) assess community pharmacists' perceptions of what impact 15 key barriers have on providing opioid interventions.
This was a multi-state, cross-sectional, and descriptive survey study. Opioid interventions evaluated included prevention (e.g., OUD screening) and treatment (e.g., OUD resource referral); barriers encompassed confidence and knowledge, work environment, provider interactions, and patient interactions. Respondents were recruited from 3 community pharmacy practice-based research networks in the Midwest and South regions of the US. Recruitment and telephone survey administration occurred between December 2021 and March 2022. Descriptive statistics were computed and open-ended items were reviewed to identify common themes.
Sixty-nine of 559 pharmacists contacted (12.3%) completed the survey. All opioid interventions were reported to be provided less frequently than indicated in practice. Screening and referral interventions were provided least frequently, at 1.2 and 1.6 times on average, respectively, to the last 10 patients for which respondents felt each intervention was needed. Patient refusal, minimal or no reimbursement, inadequate staffing and time, and negative patient reactions were identified as the highest-impact barriers to providing opioid interventions. Approximately 26% of respondents agreed or strongly agreed that pharmacy school adequately prepared them to provide opioid interventions in practice.
Prioritizing the resolution of pharmacy work environment barriers will support pharmacists in routinely providing opioid interventions. Changes in Doctor of Pharmacy curricula and continuing education are also indicated to further prepare pharmacists to engage in opioid-related harm reduction.
社区药剂师非常适合参与与阿片类药物相关的减少伤害活动（即阿片类药物干预）。然而，已经确定了提供这些干预措施的几个障碍。比较阿片类药物干预的频率，并确定哪些障碍被认为对提供干预措施的影响最大，将为增加药店中阿片类药物使用障碍（OUD）的护理机会提供有价值的信息。
（1）描述社区实践环境中 9 种阿片类药物干预措施的频率，（2）评估社区药剂师对 15 个关键障碍对提供阿片类药物干预措施的影响的看法。
这是一项多州、横断面和描述性调查研究。评估的阿片类药物干预措施包括预防（例如，OUD 筛查）和治疗（例如，OUD 资源转介）；障碍包括信心和知识、工作环境、提供者互动和患者互动。受访者从美国中西部和南部地区的 3 个社区药房实践研究网络中招募。招募和电话调查管理于 2021 年 12 月至 2022 年 3 月之间进行。计算了描述性统计数据，并审查了开放式项目，以确定共同主题。
在联系的 559 名药剂师中，有 69 名（12.3%）完成了调查。所有阿片类药物干预措施的提供频率均低于实际情况。筛查和转介干预措施的提供频率最低，平均分别为过去 10 名需要进行每项干预措施的患者提供 1.2 次和 1.6 次。患者拒绝、报销金额低或无报销、人员配备和时间不足以及患者反应消极被确定为提供阿片类药物干预措施的最高影响障碍。约有 26%的受访者表示同意或强烈同意药学学校为他们在实践中提供阿片类药物干预措施做好了充分准备。
优先解决药房工作环境障碍将支持药剂师常规提供阿片类药物干预措施。还需要对药学博士课程和继续教育进行更改，以进一步使药剂师能够参与与阿片类药物相关的减少伤害。
