Availability of and attitudes towards harm reduction services: a rural pharmacy perspective

Grace Marley; Erin Blythe; Salisa Westrick; Delesha M Carpenter

doi:10.1016/j.japh.2024.102291

Availability of and attitudes towards harm reduction services: a rural pharmacy perspective

J Am Pharm Assoc (2003). 2024 Nov 15:102291. doi: 10.1016/j.japh.2024.102291. Online ahead of print.

Authors

Grace Marley¹, Erin Blythe², Salisa Westrick³, Delesha M Carpenter⁴

Affiliations

¹ UNC Eshelman School of Pharmacy, 201 Pharmacy Lane, CB 7355, Chapel Hill, NC, 27599-7355, USA. Electronic address: Grace_trull@unc.edu.
² Auburn University Harrison College of Pharmacy, Department of Pharmacy Practice, 1330 Walker Building, Auburn, AL 36849, USA.
³ Auburn University Harrison College of Pharmacy, Dept. of Health Outcomes Research and Policy, 4306 Walker Building, Auburn, AL 36849, USA.
⁴ UNC Eshelman School of Pharmacy, 201 Pharmacy Lane, CB 7355, Chapel Hill, NC, 27599-7355, USA.

PMID: 39551238
DOI: 10.1016/j.japh.2024.102291

Abstract

Background: There's limited information available about the range of harm reduction (HR) services provided by rural pharmacies.

Objective: This study's objectives are to describe the types of HR services offered by rural pharmacies and examine pharmacists' attitudes and willingness to offer those services.

Methods: A cross-sectional online survey was sent to pharmacists who are members of a practice-based research network for rural community pharmacies. Pharmacists reported the frequency to which their pharmacy engage in as well as their willingness to offer the following HR services: naloxone dispensing; buprenorphine dispensing; point of care testing for human immunodeficiency virus (HIV) and Hepatitis C (HCV); and non-prescription syringe (NPS) sales. Also, pharmacists' knowledge and willingness to sell drug test strips and attitudes towards people who inject drugs (PWID) were assessed. Descriptive statistics were calculated.

Results: A total of 61 pharmacists completed the survey (completion rate= 45.2%). Most reported dispensing naloxone 2-3 times per month (90.2%), and a third dispensed buprenorphine daily (32.8%). Only one pharmacy offered HIV testing, and none offered HCV testing. Most pharmacies (65.6%) had a policy regarding the sale of NPS, with 21.3% reporting they never dispense non-prescription syringes. Many pharmacists were willing to sell fentanyl test strips (67.2%) and xylazine test strips (50.8%). Pharmacists' most negative attitudes related to believing PWID customers make other customers feel uncomfortable and that providers keep patients on buprenorphine for too long.

Conclusions: Many rural community pharmacists engage in HR services and are willing to offer more. However, stigmatizing attitudes highlight the need for pharmacy-focused HR training to reduce stigma and increase knowledge.

Keywords: HIV; Hepatitis C; buprenorphine; community pharmacy, harm reduction; fentanyl test strip; opioid use disorder; rural health; syringe exchange; xylazine test strip.