Abstract
Aims and methodDispensing of methadone to individuals with opioid dependence is a discretionary service and many independent pharmacies remain unwilling to do this. We aimed to determine whether there was any correlation between negative stigmatised attitude towards these individuals and the likelihood of methadone dispensing. The 20-point Attitude to Mental Illness Questionnaire (AMIQ) was used to assess stigmatised attitudes in a cluster randomised sample of managers of community pharmacies in England.ResultsThe response rate was 66%. The AMIQ stigma scores had a median difference of 1 and effect size of 0.42 in favour of those pharmacies which dispensed methadone (mean = 0.53; n = 138) compared with those who did not (mean = 0.93; n = 69; P <0.001).Clinical implicationsThe results show a clear behavioural distinction (discrimination) based on stigmatised attitudes towards individuals with opioid dependence. This may arise because managers with stigmatised attitudes refuse to dispense methadone to this group. Conversely, familiarity with these individuals may have a de-stigmatising effect.
Highlights
Clinical implications The results show a clear behavioural distinction based on stigmatised attitudes towards individuals with opioid dependence
The Attitude to Mental Illness Questionnaire (AMIQ) has been shown to have good psychometric properties in a sample of over 800 members of the UK general public (one component accounted for 80.2% of the variance; test-retest reliability was 0.702 (Pearson’s correlation coefficient); alternate test-reliability v
The study shows that approximately a third of independent pharmacies chose not to dispense methadone to individuals with opioid dependence
Summary
Results were received for 207 participants (response rate 66%). The mean AMIQ score for individuals with opioid dependence was 0.53 = 0.24; median 0; interquartile range (IQR) 71 to 3) for managers whose pharmacy dispensed methadone (n = 138) compared with the mean score of 70.93 = 0.29; median 71; IQR 72 to 1; n = 69) for the managers of the non-dispensing pharmacies. There was a statistically significant difference (P50.001; MannWhitney U-test; median difference 1; effect size 0.42)
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