Community Pharmacy Services for People with Drug Problems Over Two Decades in Scotland: Implications for Future Development
BACKGROUND:
In
Scotland community pharmacies are heavily involved in service delivery for
people with drug problems (PWDP) as documented through surveys of all community
pharmacies in 1995, 2000 and 2006. A further survey in 2014 enabled trends in
service demand/provision to be analysed and provides insight into future
development.
METHODS:
The lead
pharmacist in every Scottish pharmacy (n=1246) was invited to complete a postal
questionnaire covering attitudes towards PWDP and service provision and level
of involvement in services (needle exchange, dispensing for PWDP and methadone
supervision). Additional questions covered new services of take-home naloxone
(THN) and pharmacist prescribing for opioid dependence. Telephone follow-up of
non-responders covered key variables. A comparative analysis of four
cross-sectional population surveys of the community pharmacy workforce (1995,
2000, 2006 and 2014) was undertaken.
RESULTS:
Completed
questionnaires were returned by 709 (57%) pharmacists in 2014. Key variables
(questionnaire or telephone follow-up) were available from 873 (70%). The
proportion of pharmacies providing needle exchange significantly increased from
1995 to 2014 (8.6%, 9.5%, 12.2%, 17.8%) as did the proportion of
pharmacies dispensing for the treatment of drug misuse (58.9%, 73.4%, 82.6% and
88%). Methadone was dispensed to 16,406 individuals and
buprenorphine to 1777 individuals (increased from 12,400 and 192 respectively
in 2006). Attitudes improved significantly from 1995 to 2014 (p<0.001).
Being male and past training in drug misuse significantly predicted higher
attitude scores (p<0.05) in all four years. Attitude score was a
consistently significant predictor in all four years for dispensing for the
treatment of drug misuse and providing needle exchange. In 2014, 53% of pharmacists felt part of the addiction team and 27.7%
did not feel their role was valued by them. Nine pharmacists prescribed for
opioid dependence.
CONCLUSION:
It
is possible for pharmacy workforce attitudes and service engagement to improve
over time. Training was key to these positive trends. Communication with the
wider addiction team could be further developed.
- 1Centre of Academic Primary Care, Polwarth Building, University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD, United Kingdom. Electronic address: c.i.math@abdn.ac.uk.
- 2Institute of Applied Health Sciences, University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD, United Kingdom.
- 3Centre of Academic Primary Care, Polwarth Building, University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD, United Kingdom.
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