Zalmai Rana, Hill Lucas G, Loera Lindsey J, Mosgrove Quinn, Brown Carolyn
J Am Pharm Assoc (2003). 2023 Sep-Oct;63(5):1558-1565.e4. doi: 10.1016/j.japh.2023.06.010. Epub 2023 Jun 16.
Buprenorphine/naloxone (BUP/NX) for opioid use disorder (OUD) is associated with positive health outcomes; however, challenges accessing prescribed BUP/NX at community pharmacies have been identified.
The theory of planned behavior was applied to determine whether independent community pharmacists' attitudes toward dispensing BUP/NX for OUD predict intentions to dispense.
A 40-item survey was administered to 185 Texas Community Pharmacy Enhanced Services Network pharmacists. The survey assessed intentions to dispense BUP/NX (3 items), attitudes toward BUP/NX (24 items), current barriers to dispensing BUP/NX (2 items), and demographics (10 items). Inferential statistics determined associations among pharmacists' attitudes, practice setting characteristics, and intentions to dispense BUP/NX. Regression analysis determined whether attitude predicted intention to dispense BUP/NX, controlling for practice setting and demographic characteristics.
Responses were obtained from 82 community independent pharmacists (response rate = 44%). Respondents were predominantly non-Hispanic white (45.8%) and women (56.6%) and practiced in pharmacies with an average 1129.1 (± 1034.5) dispensed prescriptions/week. Pharmacists had positive intentions (6.2 ± 3.5) and attitudes (14.4 ± 24.9) toward dispensing BUP/NX and attitudes did not predict intentions to dispense (P = 0.330). Positive drivers of attitude were related to improving patient outcomes, fulfilling a community need, and absence of conflicts with pharmacists' personal and religious beliefs. A negative driver of attitude was financial reimbursement/loss. Pharmacists dispensing 2000 or more prescriptions/week had higher intentions (b = 3.22, P = 0.014) to dispense than those dispensing less than 500 prescriptions/week. The most common barrier to dispense BUP/NX was "refill was too soon" (54.8%).
Community independent pharmacists had positive attitudes toward and intentions of dispensing BUP/NX for OUD. However, attitudes did not predict intentions to dispense. Negative drivers of attitudes were related to factors not within pharmacists' control, such as time to refill or financial reimbursement.Future studies focused on community pharmacy-based access to BUP/NX are warranted to elucidate issues that are impactful in improving pharmacists' dispensing intentions and behavior.
丁丙诺啡/纳洛酮（BUP/NX）用于治疗阿片类物质使用障碍（OUD）与积极的健康结果相关；然而，已发现社区药房获取处方BUP/NX存在挑战。
应用计划行为理论来确定独立社区药剂师对为OUD患者配药BUP/NX的态度是否能预测配药意愿。
对185名得克萨斯州社区药房增强服务网络的药剂师进行了一项包含40个条目的调查。该调查评估了配药BUP/NX的意愿（3个条目）、对BUP/NX的态度（24个条目）、当前配药BUP/NX的障碍（2个条目）以及人口统计学信息（10个条目）。推断性统计确定了药剂师的态度、执业环境特征与配药BUP/NX意愿之间的关联。回归分析确定了态度是否能预测配药BUP/NX的意愿，并控制了执业环境和人口统计学特征。
从82名社区独立药剂师处获得了回复（回复率 = 44%）。受访者主要为非西班牙裔白人（45.8%）和女性（56.6%），在平均每周有1129.1（±1034.5）张处方配药的药房工作。药剂师对配药BUP/NX有积极的意愿（6.2 ± 3.5）和态度（14.4 ± 24.9），且态度不能预测配药意愿（P = 0.330）。态度的积极驱动因素与改善患者结局、满足社区需求以及与药剂师个人和宗教信仰无冲突有关。态度的消极驱动因素是经济补偿/损失。每周配药2000张或更多的药剂师比每周配药少于500张的药剂师有更高的配药意愿（b = 3.22，P = 0.014）。配药BUP/NX最常见的障碍是“重新配药太快”（54.8%）。
社区独立药剂师对为OUD患者配药BUP/NX有积极的态度和意愿。然而，态度不能预测配药意愿。态度的消极驱动因素与药剂师无法控制的因素有关，如重新配药时间或经济补偿。未来有必要开展聚焦于基于社区药房获取BUP/NX的研究，以阐明对改善药剂师配药意愿和行为有影响的问题。
