Attitudes and perceptions of naloxone dispensing among a sample of Massachusetts community pharmacy technicians

Abstract

Objectives: There is limited research on the attitudes of pharmacy technicians toward pharmacy naloxone provision, despite their widespread role in the pharmacy. We examined attitudes and perceptions of pharmacy technicians in the provision of naloxone in a sample of Massachusetts pharmacies. Design: Thirty-nine community retail pharmacies from 1 U.S. chain were purposely sampled in 13 municipalities across Massachusetts. Pharmacies were divided into high-risk municipalities (HRMs) versus low-risk municipalities (LRMs) based on the state average opioid-related death rate from 2011 to 2015. Setting and participants: A pharmacy technician working in each pharmacy was administered an in-person survey. Survey topics included technician beliefs about current naloxone provision practices; patient groups at greater risk of overdose; whether individuals filling prescriptions would benefit from naloxone; and whether individuals purchasing syringes would benefit from naloxone. Outcome measures: Closed-ended responses were analyzed by Mann-Whitney U, Fisher exact, and chi-square tests. Open-ended responses were summarized for themes and then contrasted by municipality risk status. Results: Technician participation was 100% (n ¼ 39). Technicians in both groups believed they could identify patient groups at risk of overdose in their practice, but HRM technicians recognized the need for naloxone for more of their at-risk patients (81% in HRM vs. 33% in LRM believed > 25% of patients need naloxone, P < 0.01). A willingness to provide naloxone was high (> 89%) in both groups. Open-ended responses revealed commonalities between groups, including the belief that patients need lower-cost naloxone, and a lack of patient and technician awareness that naloxone could prevent overdose in individuals at risk through use of prescription opioids not just through use of illicit drugs. Conclusion: Pharmacy technicians would benefit from overdose prevention training and are well positioned to recognize overdose risk and offer preventive interventions, such as naloxone. Among technicians, there is a high willingness to be involved in implementing broader naloxone access in pharmacies.

If we build it, will they come? Perspectives on pharmacy-based naloxone among family and friends of people who use opioids: a mixed methods study

“…Contrary to bystanders’ perceptions about possible future discrimination, most pharmacists are supportive of naloxone, do not hold discriminatory attitudes towards naloxone patients, and are largely concerned that offering naloxone will offend or embarrass patients [ 31 ]. Additionally, pharmacy technicians are highly willing to provide naloxone and overdose education [ 35 ]. Universal offers of naloxone may be a useful intervention to close the gap between the perceptions of bystanders and pharmacists.…”

Examining nonprescription syringe sales in Massachusetts and Rhode Island community pharmacies

“…The large volume of NPS sales and variety of staff members selling and stocking NPS may explain the moderate correlation with administrative NPS sales data. Technicians and interns more commonly sell NPS than pharmacists and pharmacy managers; 29 self-reported data obtained from pharmacists may be less precise based on fewer interactions in some stores. Because pharmacy staff were surveyed by telephone, there is a potential for social desirability bias.…”

CONSIDER New Mexico: Effects of naloxone training among pharmacists and pharmacy technicians

“…Certified pharmacy technicians have been trained to provide other health services such as immunizations, 32 and previous research has reported that technicians would benefit from overdose prevention training focused on increasing access to naloxone. 14 However, existing literature related to naloxone dispensing at pharmacies has primarily focused on the attitudes of pharmacists and their role in combating the opioid crisis. 33 CONSIDER New Mexico results demonstrated a statistically significant improvement in the intent of technicians to regularly introduce the potential need for naloxone to patients at risk of an opioid overdose following the intervention.…”

“…12,13 Emerging research shows that pharmacy technicians are willing to identify patients who might benefit from having naloxone available and support dispensing. 14 However, stigma toward opioid-using patients is a substantial barrier. 15,16 Pharmacy technicians can benefit from training and professional development regarding opioid use disorder, implicit bias, and nonjudgmental approaches.…”