Rural community pharmacist willingness to dispense Suboxone® - A secret shopper investigation in South-Central Appalachia
Background: Buprenorphine access is limited for patients with opioid use disorder, especially in rural areas. Telephone audits have identified pharmacist limitations to the dispensing of buprenorphine particularly in independent pharmacies in comparison to chain pharmacies and in rural areas. The ob...
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| Format: | Article |
| Language: | English |
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Elsevier
2021-12-01
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| Series: | Exploratory Research in Clinical and Social Pharmacy |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667276621000822 |
| _version_ | 1818844327360593920 |
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| author | Grace Trull Erin Major Chase Harless William Zule Bayla Ostrach Delesha Carpenter |
| author_facet | Grace Trull Erin Major Chase Harless William Zule Bayla Ostrach Delesha Carpenter |
| author_sort | Grace Trull |
| collection | DOAJ |
| description | Background: Buprenorphine access is limited for patients with opioid use disorder, especially in rural areas. Telephone audits have identified pharmacist limitations to the dispensing of buprenorphine particularly in independent pharmacies in comparison to chain pharmacies and in rural areas. The objective of this study was to assess rural community pharmacists' stated willingness to dispense buprenorphine-naloxone, and document potential bias and or stigma that the shopper experiences when asking about buprenorphine- naloxone. Methods: To assess pharmacist willingness, a telephone audit of 15 rural Appalachian North Carolina pharmacies was conducted. Three secret shopper scenarios were utilized including one shopper posing as a new patient, one shopper posing as an out of state patient, and one shopper first asking about buying syringes. Encounters were noted by willingness to dispense buprenorphine, and shoppers were to note any potential stigma and or bias that they experienced while asking for Suboxone®. Results: Overall, 60% of pharmacies audited indicated willingness to dispense buprenorphine without reservation, and 31% indicated willingness to dispense only under certain circumstances. Pharmacies tended to add more conditions to dispensing to the out of state patient (46%), such as only dispensing if the practitioner was from in state in comparison to the other shopper scenarios. Potential stigma and bias were encountered in 40% of the 45 encounters. Conclusion: Although pharmacies overall seemed willing to dispense, nuances regarding who pharmacies are most likely to dispense are felt in rural areas. Buprenorphine access limitations were more common in independent pharmacies and more often placed on patients from out of state. Pharmacy- directed education is necessary to reduce stigma and bias and increase patient access to buprenorphine. |
| first_indexed | 2024-12-19T05:12:00Z |
| format | Article |
| id | doaj.art-24424d92cecf4477897e7e1fa396545a |
| institution | Directory Open Access Journal |
| issn | 2667-2766 |
| language | English |
| last_indexed | 2024-12-19T05:12:00Z |
| publishDate | 2021-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Exploratory Research in Clinical and Social Pharmacy |
| spelling | doaj.art-24424d92cecf4477897e7e1fa396545a2022-12-21T20:34:46ZengElsevierExploratory Research in Clinical and Social Pharmacy2667-27662021-12-014100082Rural community pharmacist willingness to dispense Suboxone® - A secret shopper investigation in South-Central AppalachiaGrace Trull0Erin Major1Chase Harless2William Zule3Bayla Ostrach4Delesha Carpenter5University of North Carolina at Chapel Hill, Eshelman School of Pharmacy, 301 Pharmacy Lane, CB#7355, Chapel Hill, NC 27599, USA; Corresponding author.UNC Health Sciences at Mountain Area Health Education Center, 121 Henderson Road, Asheville, NC 28803, USAUNC Health Sciences at Mountain Area Health Education Center, 121 Henderson Road, Asheville, NC 28803, USAResearch Triangle Institute International, 3040 East Cornwallis Road, Research Triangle Park, NC 27709, USABoston University, School of Medicine, 72 East Concord St, Boston, MA 02118, USAUniversity of North Carolina at Chapel Hill, Eshelman School of Pharmacy, 1 University Heights, CPO 2125, Asheville, NC 28804, USABackground: Buprenorphine access is limited for patients with opioid use disorder, especially in rural areas. Telephone audits have identified pharmacist limitations to the dispensing of buprenorphine particularly in independent pharmacies in comparison to chain pharmacies and in rural areas. The objective of this study was to assess rural community pharmacists' stated willingness to dispense buprenorphine-naloxone, and document potential bias and or stigma that the shopper experiences when asking about buprenorphine- naloxone. Methods: To assess pharmacist willingness, a telephone audit of 15 rural Appalachian North Carolina pharmacies was conducted. Three secret shopper scenarios were utilized including one shopper posing as a new patient, one shopper posing as an out of state patient, and one shopper first asking about buying syringes. Encounters were noted by willingness to dispense buprenorphine, and shoppers were to note any potential stigma and or bias that they experienced while asking for Suboxone®. Results: Overall, 60% of pharmacies audited indicated willingness to dispense buprenorphine without reservation, and 31% indicated willingness to dispense only under certain circumstances. Pharmacies tended to add more conditions to dispensing to the out of state patient (46%), such as only dispensing if the practitioner was from in state in comparison to the other shopper scenarios. Potential stigma and bias were encountered in 40% of the 45 encounters. Conclusion: Although pharmacies overall seemed willing to dispense, nuances regarding who pharmacies are most likely to dispense are felt in rural areas. Buprenorphine access limitations were more common in independent pharmacies and more often placed on patients from out of state. Pharmacy- directed education is necessary to reduce stigma and bias and increase patient access to buprenorphine.http://www.sciencedirect.com/science/article/pii/S2667276621000822BuprenorphineOpioid use disorderPharmacistAccessRural |
| spellingShingle | Grace Trull Erin Major Chase Harless William Zule Bayla Ostrach Delesha Carpenter Rural community pharmacist willingness to dispense Suboxone® - A secret shopper investigation in South-Central Appalachia Exploratory Research in Clinical and Social Pharmacy Buprenorphine Opioid use disorder Pharmacist Access Rural |
| title | Rural community pharmacist willingness to dispense Suboxone® - A secret shopper investigation in South-Central Appalachia |
| title_full | Rural community pharmacist willingness to dispense Suboxone® - A secret shopper investigation in South-Central Appalachia |
| title_fullStr | Rural community pharmacist willingness to dispense Suboxone® - A secret shopper investigation in South-Central Appalachia |
| title_full_unstemmed | Rural community pharmacist willingness to dispense Suboxone® - A secret shopper investigation in South-Central Appalachia |
| title_short | Rural community pharmacist willingness to dispense Suboxone® - A secret shopper investigation in South-Central Appalachia |
| title_sort | rural community pharmacist willingness to dispense suboxone r a secret shopper investigation in south central appalachia |
| topic | Buprenorphine Opioid use disorder Pharmacist Access Rural |
| url | http://www.sciencedirect.com/science/article/pii/S2667276621000822 |
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