Wright-De Agüero L, Weinstein B, Jones T S, Miles J
Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
J Acquir Immune Defic Syndr Hum Retrovirol. 1998;18 Suppl 1:S102-10. doi: 10.1097/00042560-199802001-00018.
We assessed the impact of the 1992 change in Connecticut syringe prescription laws on pharmacy sales and pharmacy managers' sales practices. A mail survey was conducted in 1994 of all current pharmacy managers in the five largest cities in Connecticut (Hartford, New Haven, Waterbury, Bridgeport, and Stamford) and a random sample of those practicing in all other areas. Of these, 89.3% of the pharmacies in the five largest cities and 85.1% in the other areas had ever sold syringes without a prescription since the July 1992 law went into effect. Most pharmacists identified safety issues as very important in their personal decision about the sale of syringes without a prescription. Although the purpose of the change in the prescription law was to provide expanded access to sterile syringes by injection drug users (IDUs), only 31.4% of the managers who were allowed to sell in all instances and 18.1% of those who sold at their discretion were very willing to sell syringes to IDUs. In the logistic regression model of pharmacies with a sell-in-all-instances policy, the perceived benefit of the sale of syringes on health and community well-being was the only influence independently associated with managers support for nonprescription sales. Overall, managers reported they did not know what other pharmacists thought (40.4%) or did (42.9%) regarding the sale of syringes. When pharmacists had discretion over syringe sales, managers' beliefs about what other Connecticut pharmacists thought and did about the nonprescription sale of syringes remained a significant influence on the degree of support for sales. Most pharmacies implemented and maintained policies permitting the sale of syringes without a prescription. Several issues, including risk of discarded contaminated syringes around pharmacies and in the community and reluctance to sell to IDUs, reduced pharmacists willingness to sell syringes. Efforts to incorporate pharmacists as active partners in HIV prevention in IDUs should promote the sale of syringes without a prescription to IDUs as acceptable public health practice.
我们评估了1992年康涅狄格州注射器处方法律的变化对药房销售及药房经理销售行为的影响。1994年,我们对康涅狄格州五个最大城市(哈特福德、纽黑文、沃特伯里、布里奇波特和斯坦福德)的所有现任药房经理以及其他所有地区的执业药师进行了随机抽样邮件调查。其中,自1992年7月法律生效以来,五个最大城市中89.3%的药房以及其他地区85.1%的药房曾在无处方的情况下销售过注射器。大多数药剂师认为安全问题在他们个人关于无处方销售注射器的决定中非常重要。尽管处方法律变化的目的是让注射吸毒者(IDUs)能更方便地获得无菌注射器,但在所有情况下都被允许销售的经理中,只有31.4%非常愿意向注射吸毒者出售注射器,而自行决定销售的经理中这一比例为18.1%。在实行全面销售政策的药房的逻辑回归模型中,销售注射器对健康和社区福祉的感知益处是与经理支持非处方销售独立相关的唯一影响因素。总体而言,经理们表示他们不知道其他药剂师对注射器销售的看法(40.4%)或做法(42.9%)。当药剂师对注射器销售有自行决定权时,经理们对其他康涅狄格州药剂师对注射器非处方销售的看法和做法的信念,仍然对销售支持程度有重大影响。大多数药房实施并维持了允许无处方销售注射器的政策。包括药房及社区周围废弃受污染注射器的风险以及不愿向注射吸毒者销售等几个问题,降低了药剂师销售注射器的意愿。将药剂师纳入注射吸毒者艾滋病毒预防的积极合作伙伴的努力,应促使将向注射吸毒者无处方销售注射器作为可接受的公共卫生做法。