Abstract
BackgroundPharmacists’ role in harm reduction is expanding in many states, yet there are limited data on pharmacists’ willingness to participate in harm reduction activities. This study assessed community pharmacists’ willingness to participate in one harm reduction initiative: syringe/needle exchange.MethodsIn 2015, all Kentucky pharmacists with active licenses were emailed a survey that examined attitudes towards participation in syringe/needle exchange. Response frequencies were calculated for community pharmacist respondents. Ordinal logistic regression estimated the impact of community pharmacist characteristics and attitudes on willingness to provide clean needles/syringes to people who inject drugs and to dispose of used syringes/needles, where both dependent variables were defined as Likert-type questions on a scale of 1 (not at all willing) to 6 (very willing).ResultsOf 4699 practicing Kentucky pharmacists, 1282 pharmacists responded (response rate = 27.3%); the majority (n = 827) were community pharmacists. Community pharmacists were divided on willingness to provide clean needles/syringes, with 39.1% not willing (score 1 or 2 of 6) and 30% very willing (score 5 or 6 of 6). Few were willing to dispose of used needles/syringes, with only 18.7% willing. Community pharmacists who agreed that pharmacists could have significant public health impact by providing access to clean needles expressed 3.56 times more willingness to provide clean needles (95% CI 3.06–4.15), and 2.04 times more willingness to dispose of used needles (95% CI 1.77–2.35). Chain/supermarket pharmacists (n = 485, 58.6% of community pharmacies) were 39% less likely to express willingness to dispose of used needles (95% CI 0.43–0.87) when compared with independent community pharmacists (n = 342, 41.4% of community pharmacies). Independent pharmacists reported different barriers (workflow) than their chain/supermarket pharmacist colleagues (concerns of clientele).ConclusionsKentucky community pharmacists were more willing to provide clean needles than to dispose of used needles. Strategies to mitigate barriers to participation in syringe/needle exchange are warranted.
Highlights
Pharmacists’ role in harm reduction is expanding in many states, yet there are limited data on pharmacists’ willingness to participate in harm reduction activities
Community pharmacists who expressed agreement with the statement that pharmacists could have significant public health impact by providing access to clean syringes/needles for people who inject drugs (PWID) were more likely to express willingness to provide clean needles and syringes and were more likely to express willingness to dispose of used needles and syringes
Results were similar in the alternative specifications to the results presented in Table 2, with the only significant covariate for both willingness to provide clean needles and willingness to dispose of used needles found among those who agreed that pharmacists could have a significant public health impact by providing access to syringes/needles for IV drug users and who currently sell needles/syringes
Summary
Pharmacists’ role in harm reduction is expanding in many states, yet there are limited data on pharmacists’ willingness to participate in harm reduction activities. This study assessed community pharmacists’ willingness to participate in one harm reduction initiative: syringe/needle exchange. Harm reduction activities, including NEPs for PWID, have been led by public health communities for decades in the USA. The pharmacists’ role in harm reduction is being expanded in several states as part of the effort to combat the spread of infectious disease and increases in overdose mortality [7]. Though NEPs have been shown to be both effective [8] and cost-effective [9] interventions for disease prevention in previous studies, they remain politically controversial [10] in the general populace, manifesting as inconsistencies in federal and state funding for NEP services [11]
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