Vieira Leticia E B, Ostrach Bayla, Westrick Salisa, Kennelty Korey A, Look Kevin A, Carpenter Delesha M
University of North Carolina at Chapel Hill, UNC Eshelman School of Pharmacy, Chapel Hill, NC, 27599-7573, USA.
Fruit of Labor Action Research & Technical Assistance, LLC, Marshall, NC, Boston University, Chobanian & Avedisian School of Medicine, 85 E. Newton St Fuller Building, Boston, MA, 02118, USA.
Res Social Adm Pharm. 2025 May;21(5):361-370. doi: 10.1016/j.sapharm.2025.01.014. Epub 2025 Jan 27.
Opioid overdose is an ongoing public health issue in the rural United States and can be countered by increasing access to the opioid antagonist naloxone. Community pharmacists are well-positioned to offer and dispense naloxone to patients at risk of opioid overdose, but still experience a range of communication barriers. Understanding rural patient communication preferences is essential to prepare pharmacists to discuss naloxone in a patient-centered manner.
To explore rural community pharmacists' and patients' naloxone communication preferences employing the Linguistic Model of Patient Participation in Care (LM).
In-depth qualitative interviews were conducted with 40 community pharmacists and 40 patients from rural areas in Alabama, Iowa, North Carolina, and Wisconsin. After a thematic analysis of the interview transcripts, three code reports were selected for a secondary qualitative analysis informed by the LM.
All elements described in the LM (Predisposing Factors, Enabling Factors, And Provider's Communication Style) were associated with patient-pharmacist naloxone communication. The analysis revealed four additional factors not accounted for in the model: Stigma, Privacy, Insurance Coverage and Price, and Collaboration with Physician.
Patient-pharmacist naloxone conversations are impacted by the factors described in the LM, as well as several pharmacy-specific factors which were included in an adapted conceptual model. Future studies should consider these findings when developing interventions to improve patient-pharmacist communication and pharmacists can utilize the practical tips provided to actively address the opioid epidemic.
阿片类药物过量在美国农村地区仍是一个持续存在的公共卫生问题,增加阿片类拮抗剂纳洛酮的可及性可应对这一问题。社区药剂师处于有利位置,能够为有阿片类药物过量风险的患者提供并配发纳洛酮,但仍面临一系列沟通障碍。了解农村患者的沟通偏好对于让药剂师以患者为中心讨论纳洛酮至关重要。
运用患者参与护理的语言模型(LM)探索农村社区药剂师和患者对纳洛酮的沟通偏好。
对来自阿拉巴马州、爱荷华州、北卡罗来纳州和威斯康星州农村地区的40名社区药剂师和40名患者进行了深入的定性访谈。在对访谈记录进行主题分析后,选择了三份编码报告进行基于LM的二次定性分析。
LM中描述的所有要素( predisposing因素、促成因素和提供者的沟通风格)都与患者 - 药剂师关于纳洛酮的沟通相关。分析揭示了该模型未涵盖的另外四个因素:耻辱感、隐私、保险覆盖范围和价格以及与医生的合作。
患者 - 药剂师关于纳洛酮的对话受到LM中描述的因素以及纳入适应性概念模型的几个特定于药房的因素的影响。未来研究在制定改善患者 - 药剂师沟通的干预措施时应考虑这些发现,并且药剂师可以利用所提供的实用提示来积极应对阿片类药物流行问题。