TY - JOUR
AU - G. Broussard
AU - K. C. Hohmeier
AU - C. Field
AU - A. J. Gordon
AU - K. Carlston
AU - A. Cernasev
AU - M. Tyszko
AU - A. M. Snyder
AU - G. Cochran
A1 - 
AB - INTRODUCTION: A significant risk for overdose among patients prescribed opioid medications is co-use of alcohol. Community pharmacies are underutilized as a resource to prevent and address co-use. The barriers and facilitators that promote or impede the adoption of universal alcohol screening and intervention at point of opioid medication dispensing are unknown. We assessed community pharmacy leaders, pharmacists, and technician's perceptions towards the implementation of a pharmacy-based screening/intervention for the co-use of opioids and alcohol among patients. METHODS: We conducted a multi-method study that included one-time key informant interviews combined with a close-ended survey to inform our understanding of pharmacy system/practice-level barriers and facilitators for universal screening and intervention. Participants were recruited from Utah and Tennessee and were required to have active employment as pharmacy leaders, pharmacists, or technicians, be English-speaking, and believe they could provide feedback regarding co-use screening and intervention within community pharmacies. Interviews used the Consolidated Framework for Implementation Research and the Organizational Readiness for Implementing Change assessment. Qualitative analysis included both inductive and deductive coding. Themes followed a cycle of open, initial coding whereby codes were derived inductively from the data. RESULTS: Themes from interviews (N = 68) included a) emphasizing a need to overcome the stigma associated with patients who engage in co-use and a mindset shift to treat the challenges and risks associated, b) need for corporate-level support, management buy-in, and c) appropriate technology to support the workflow including system-wide changes to support the integration of medication therapy management services within community pharmacies. However, barriers were offset by pharmacists eager to understand their role in screening patients and reiterated a focus on patient-centered care to achieve this goal. From the ORIC assessment, 75 % (n = 51) of respondents reported that community pharmacy staff wanted to implement the screening and intervention, and 69.1 % (n = 47) reported motivation to implement the screening and intervention. Finally, 67.6 % (n = 46) felt that community pharmacies are committed to implementing the screening and intervention, but only 10.3 % (n = 7) expressed strong support to do "whatever it takes" to implement the screening and intervention. CONCLUSION: These results provide critical insights into implementation strategies for the adoption of brief intervention by community pharmacists. These data are foundational to developing strategies for a powered trial and possible future system/practice-level implementation of universal alcohol screening and intervention for co-use.
AD - University of Utah, Division of Epidemiology, 295 Chipeta Way, Salt Lake City, UT 84108, United States of America. Electronic address: grace.broussard@hsc.utah.edu.; University of Tennessee Health Science Center, 301 S. Perimeter Park Drive, Suite 220, Nashville, TN 37211, United States of America. Electronic address: khohmeie@uthsc.edu.; University of Texas, El Paso, Department of Psychology, El Paso, TX, 79968, United States of America. Electronic address: cfield@utep.edu.; University of Utah, Division of Epidemiology, 295 Chipeta Way, Salt Lake City, UT 84108, United States of America. Electronic address: adam.gordon@hsc.utah.edu.; University of Utah, Division of Epidemiology, 295 Chipeta Way, Salt Lake City, UT 84108, United States of America. Electronic address: kristi.carlston@hsc.utah.edu.; University of Tennessee Health Science Center, 301 S. Perimeter Park Drive, Suite 220, Nashville, TN 37211, United States of America. Electronic address: acernase@uthsc.edu.; University of Utah, Division of Epidemiology, 295 Chipeta Way, Salt Lake City, UT 84108, United States of America. Electronic address: m.tyszko@utah.edu.; University of Utah, Division of Epidemiology, 295 Chipeta Way, Salt Lake City, UT 84108, United States of America. Electronic address: ashley.snyder@utah.edu.; University of Utah, Division of Epidemiology, 295 Chipeta Way, Salt Lake City, UT 84108, United States of America. Electronic address: jerry.cochran@hsc.utah.edu.
AN - 39672335
BT - J Subst Use Addict Treat
C5 - Healthcare Disparities; Opioids & Substance Use
DA - Feb
DO - 10.1016/j.josat.2024.209606
DP - NLM
ET - 20241212
JF - J Subst Use Addict Treat
LA - eng
N2 - INTRODUCTION: A significant risk for overdose among patients prescribed opioid medications is co-use of alcohol. Community pharmacies are underutilized as a resource to prevent and address co-use. The barriers and facilitators that promote or impede the adoption of universal alcohol screening and intervention at point of opioid medication dispensing are unknown. We assessed community pharmacy leaders, pharmacists, and technician's perceptions towards the implementation of a pharmacy-based screening/intervention for the co-use of opioids and alcohol among patients. METHODS: We conducted a multi-method study that included one-time key informant interviews combined with a close-ended survey to inform our understanding of pharmacy system/practice-level barriers and facilitators for universal screening and intervention. Participants were recruited from Utah and Tennessee and were required to have active employment as pharmacy leaders, pharmacists, or technicians, be English-speaking, and believe they could provide feedback regarding co-use screening and intervention within community pharmacies. Interviews used the Consolidated Framework for Implementation Research and the Organizational Readiness for Implementing Change assessment. Qualitative analysis included both inductive and deductive coding. Themes followed a cycle of open, initial coding whereby codes were derived inductively from the data. RESULTS: Themes from interviews (N = 68) included a) emphasizing a need to overcome the stigma associated with patients who engage in co-use and a mindset shift to treat the challenges and risks associated, b) need for corporate-level support, management buy-in, and c) appropriate technology to support the workflow including system-wide changes to support the integration of medication therapy management services within community pharmacies. However, barriers were offset by pharmacists eager to understand their role in screening patients and reiterated a focus on patient-centered care to achieve this goal. From the ORIC assessment, 75 % (n = 51) of respondents reported that community pharmacy staff wanted to implement the screening and intervention, and 69.1 % (n = 47) reported motivation to implement the screening and intervention. Finally, 67.6 % (n = 46) felt that community pharmacies are committed to implementing the screening and intervention, but only 10.3 % (n = 7) expressed strong support to do "whatever it takes" to implement the screening and intervention. CONCLUSION: These results provide critical insights into implementation strategies for the adoption of brief intervention by community pharmacists. These data are foundational to developing strategies for a powered trial and possible future system/practice-level implementation of universal alcohol screening and intervention for co-use.
PY - 2025
SN - 2949-8767 (Print); 2949-8759
SP - 209606
ST - Barriers and facilitators to the implementation of screening and intervention for co-use of opioid medications and alcohol among community pharmacy patients
T1 - Barriers and facilitators to the implementation of screening and intervention for co-use of opioid medications and alcohol among community pharmacy patients
T2 - J Subst Use Addict Treat
TI - Barriers and facilitators to the implementation of screening and intervention for co-use of opioid medications and alcohol among community pharmacy patients
U1 - Healthcare Disparities; Opioids & Substance Use
U3 - 10.1016/j.josat.2024.209606
VL - 169
VO - 2949-8767 (Print); 2949-8759
Y1 - 2025
ER -