Pharmacist and Pharmacy Staff Experiences with Non-prescription (NP) Sale of Syringes and Attitudes Toward Providing HIV Prevention Services for Injection Drug Users (IDUs) in Providence, RI

Abstract

Increased access to sterile syringes among injection drug users (IDUs) has been correlated with reduced syringe sharing. Many states, including Rhode Island, have legalized non-prescription (NP) sale of syringes in pharmacies. Previous studies have suggested that training pharmacists to provide HIV-related services to IDUs may be an important opportunity to engage IDUs and provide them with such services. However, it is not clear to what extent pharmacy staff are willing to expand their roles in providing services to IDUs who come in to purchase syringes. We recruited pharmacists and pharmacy staff from the 48 pharmacies indicating NP sale of syringes in the greater Providence, RI area, to participate in an online survey consisting of demographic information; views about the current syringe laws in Rhode Island; willingness to provide HIV-related services, including referral for HIV testing, substance use treatment, and medical and social services, to IDUs; and past experiences with IDU customers. One hundred and forty-six individuals completed the online survey (32 pharmacies, 114 pharmacy staff). Most participants were employed by chain pharmacies (92%). Most participants thought that pharmacies are important resources for IDU customers (77%) and that they would be willing to provide health and prevention information/referrals to IDU customers who purchase NP syringes (59%). With respect to willingness to offer HIV prevention-related services, access to confidential space and concern about personal safety had the strongest associations with willingness to provide HIV prevention services (OR, 4.3 and 0.1, respectively). As the nature of the retail pharmacy shifts, researchers, pharmacy executives, and health care officials can build upon the willingness of pharmacists and pharmacy staff in order to address the health needs of injection drug users and other underserved populations.

Barriers to Medical Provider Support for Prescription Naloxone As Overdose Antidote for Lay Responders

“…U.K. study evaluating a "cascade" training model of clinician peer-to-peer training regarding naloxone found that the number of subsequent peer trainings conducted had been modest (Mayet et al, 2011). Future studies could test alternative training models or evaluate pharmacistled interventions, such as collaborative pharmacy practice agreement approaches (Zaller, Jeronimo, Bratberg, Case, & Rich, 2010).…”

Pharmacists and Harm Reduction: A Review of Current Practices and Attitudes

“…A survey of Rhode Island practitioners found that pharmacists felt it was their role to provide equipment and advice to IDUs to prevent the spread of infections and that providing these services in the community pharmacy setting would not disrupt regular pharmacy services. 34 Similarly, pharmacists in New York noted no increase in crime or discomfort among staff and customers following the introduction of clean needle sales, despite fears to the contrary. 15 Furthermore, pharmacists offering needle disposal services and providing sharps containers to IDUs felt that these services had reduced the number of used needles being disposed in their neighbourhoods.…”

Confronting inequities: A scoping review of the literature on pharmacist practice and health-related disparities

“…75 In 268 contrast to quantitative work, which often focus on specific dimensions (i.e., knowledge, 269 attitudes), the qualitative studies take a more in-depth look at pharmacists' experiences related to 270 particular patient populations, including their knowledge, attitudes, beliefs, and perceptions 271 related to working with patients (or potential patients). Notably, although some scholars have 272 examined the patient perspective through surveys e.g.,42, 70,72,81,95,107 and interviews or focus 273 groups, 32,69,77,113,119 or a combinations of methods, 110,116 focused study of patient attitudes, 274 understandings and experiences are less common within this literature. 275…”

“…Examples of these services 332 included non-dispensing services for those with mental illness, 35,50,70,79 sale of non-prescription 333 syringes (or methadone) to IDUs, 26,29,33,55,[57][58][59][60][62][63][64]66,69,74,76 services for those with, or at risk for, 334…”

“…clinicians' knowledge about a condition and/or commitment to caring for a patient [36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54] Aligned 214 with this literature is a small group of articles that did not use the language of stigma, but 215 attended to societal level "stereotypes" about groups or measure "negative attitudes" and related 216 service gaps for those who abuse/ misuse drugs [55][56][57][58][59][60][61][62][63][64][65][66][67][68][69] and patients with mental illness. 70-72 217 Bias.…”