Qualitative exploration of the education and skill needs of community pharmacists in Saskatoon concerning substance use disorder

Abstract

Background:

Identifying the skills and educational needs of community pharmacists concerning addiction is critical to improving the services provided for people who suffer from addiction disease (PWSAD).

Methods:

Eleven one-to-one semi-structured interviews were conducted with community pharmacists practising in the Saskatoon Health Region, Canada. The interviews were recorded and transcribed verbatim and verified with the participants. Thematic analysis was employed to analyze the transcripts.

Results:

Four major themes were identified: 1) effect of the work setting on pharmacists’ encounters with PWSAD, 2) pharmacists’ knowledge of key aspects of addiction, 3) level of support within the health care system, and 4) educational and training needs.

Conclusion:

Participants indicated that a lack of knowledge and training were major hindrances to improving the quality of the services provided to people who suffer from addiction disease. Additional practicum experience at the undergraduate level and interprofessional interactive educational sessions at the continuing educational level were key recommendations emerging from the study.

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References

Degenhardt

Hall

. Extent of illicit drug use and dependence and their contribution to the global burden of disease. Lancet 2012;379(9810):55-70.

World Health Organization. World Drug Report 2012. The contemporary drug problem: characteristics, patterns and driving factors. Available: https://www.unodc.org/documents/data-and-analysis/WDR2012/WDR_2012_Chapter2.pdf (accessed Nov. 8, 2018).

Rehm

Gnam

Popova

et al . The costs of alcohol, illegal drugs and tobacco in Canada, 2002. J Stud Alcohol Drugs 2007;68(6):886.

Rehm

Baliunas

Brochu

et al . The costs of substance abuse in Canada 2002. Ottawa (ON): Canadian Centre on Substance Abuse; 2002.

Fischer

Rehm

Brissette

et al . Illicit opioid use in Canada: comparing social, health and drug use characteristics of untreated users in five cities (OPICAN study). J Urban Health 2005;82(2):250-66.

Fischer

Russell

Murphy

Kurdyak

. Prescription opioids, abuse and public health in Canada: is fentanyl the new centre of the opioid crisis? Pharmacoepidemiol Drug Saf 2015;24(12):1334-6.

Martin

Woodall

McLellan

. Fentanyl-related deaths in Ontario, Canada: toxicological findings and circumstances of death in 112 cases (2002-2004). J Anal Toxicol 2006;30(8):603-10.

McKee

Amlani

Buxton

. Illicit fentanyl: An emerging threat to people who use drugs in BC. BC Med J 2015;57(6):235.

Ewan

Whaite

. Training health professionals in substance abuse: a review. Int J Addictions 1982;17(7):1211-29.

10.

Wyatt

Dekker

. Improving physician and medical student education in substance use disorders. J Am Osteopath Assoc 2007;107(suppl 5):ES27-ES38.

11.

Grol

Grimshaw

. From best evidence to best practice: effective implementation of change in patients’ care. Lancet 2003;362(9391):1225-30.

12.

Watson

Hughes

. Pharmacists and harm reduction: a review of current practices and attitudes. Can Pharm J (Ott) 2012;145(3):124-7.e2.

13.

Kabli

Liu

Seifert

Arnot

. Effects of academic service learning in drug misuse and addiction on students’ learning preferences and attitudes toward harm reduction. Am J Pharm Educ 2013;77(3):63.

14.

Dole

Tommasello

. Recommendations for implementing effective substance abuse education in pharmacy practice. Subst Abuse 2002;23(supp 1):263-71.

15.

Lafferty

Hunter

Marsh

. Knowledge, attitudes and practices of pharmacists concerning prescription drug abuse. J Psychoactive Drugs 2006;38(3):229-32.

16.

Watson

Hughes

. Pharmacists and harm reduction: a review of current practices and attitudes. Can Pharm J (Ott) 2012;145(3):124-7.

17.

Baldwin

Dole

Levine

et al . Survey of pharmacy substance abuse course content. Am J Pharm Educ 1994;58:47S.

18.

Baldwin

. Evaluation of alcohol and drug use attitudes and behaviours in pharmacy college faculty, part I: behaviours. Am J Pharm Educ 1990;54(3):233-38.

19.

Baldwin

. Evaluation of alcohol and drug use attitudes and behaviours in pharmacy college faculty, part II: attitudes. Am J Pharm Educ 1990;54(3):239-42.

20.

Tommasello

. Substance abuse and pharmacy practice: what community pharmacist needs to know about drug abuse and dependence. Harm Reduct J 2004;1:3.

21.

Nkansah

Mostovetsky

et al . Effect of outpatient pharmacists’ non-dispensing roles on patient outcomes and prescribing patterns. Cochrane Database Syst Rev 2010;7(7):CD000336.

22.

Finley

Crismon

Rush

. Evaluating the impact of pharmacists in mental health: a systematic review. Pharmacotherapy 2003;23(12):1634-44.

23.

Murphy

Phelan

Haslam

et al . Community pharmacists’ experiences in mental illness and addictions care: a qualitative study. Subst Abuse Treat Prev Policy 2016;11(1):1.

24.

Marshall

. Sampling for qualitative research. Fam Pract 1996;13(6):522-6.

25.

Fylan

. Semi structured interviewing. In: A handbook of research methods for clinical and health psychology. 2005:65-78. Oxford, UK.

26.

Kvale

Brinkmann

. Interviews: learning the craft of qualitative research interviewing. 2009. Thousand Oaks, CA, SAGE.

27.

Seidman

. Interviewing as qualitative research: a guide for researchers in education and the social sciences. Teachers College Press; 2013. Teacher College, Columbia University, New York.

28.

Erickson

Butters

Walko

. CAMH and harm reduction: a background paper on its meaning and application for substance use issues. 2003. Available: www.doctordeluca.com/Library/AbstinenceHR/CAMH&HR03.pdf (accessed Nov. 8, 2018).

29.

Marlatt

Larimer

Witkiewitz

. Harm reduction: pragmatic strategies for managing high-risk behaviours. New York: Guilford; 2011.

30.

Rosenberg

Melville

. Controlled drinking and controlled drug use as outcome goals in British treatment services. Addiction Res Theory 2005;13(1):85-92.

31.

Marlatt

. Harm reduction: come as you are. Addict Behav 1996;21(6):779-88.

32.

Marlatt

Witkiewitz

. Harm reduction approaches to alcohol use: health promotion, prevention and treatment. Addict Behav 2002;27(6):867-86.

33.

Agomo

. The role of community pharmacists in public health: a scoping review of the literature. J Pharm Health Serv Res 2012;3(1):25-33.

34.

Wenthur

Cross

Vernon

et al . Opinions and experiences of Indiana pharmacists and student pharmacists: the need for addiction and substance abuse education in the United States. Res Soc Admin Pharm 2013;9(1): 90-100.

35.

Spitz

Moore

Papaleontiou

et al . Primary care providers’ perspective on prescribing opioids to older adults with chronic non-cancer pain: a qualitative study. BMC Geriatr 2011;11(1):35.

36.

Greenwald

Narcessian

. Opioids for managing patients with chronic pain: community pharmacists’ perspectives and concerns. J Pain Sympt Manag 1999;17(5):369-75.

37.

Lalaguna

JLP

Ribas

Aymerich

. Addictions: a need for specific education. Proc Soc Behav Sci 2014;141:160-5.

38.

McLellan

Lewis

O’Brien

Kleber

. Drug dependence, a chronic medical illness. JAMA 2000;284(13):1689.

39.

Zweben

Clark

Smith

. Traumatic experiences and substance abuse: mapping the territory. J Psychoactive Drugs 1994;26(4):327-44.

40.

Vasse

Nijhuis

Kok

. Associations between work stress, alcohol consumption and sickness absence. Addiction 1998;93(2):231-41.

41.

Eldred

Brown

Mahabir

. Heroin addict clients’ description of their families of origin. Subst Use Misuse 1974;9(2):315-20.

42.

Dole

Tommasello

. Recommendations for implementing effective substance abuse education in pharmacy practice. Subst Abuse 2002;23(supp 1):263-71.

43.

Walters

Matson

Baer

Ziedonis

. Effectiveness of workshop training for psychosocial addiction treatments: a systematic review. J Subst Abuse Treat 2005;29(4):283-93.

44.

Ballon

Skinner

. “Attitude is a little thing that makes a big difference”: reflection techniques for addiction psychiatry training. Acad Psychiatry 2008;32(3):218-24.

45.

Madden

Graham

Straussner

et al . Interdisciplinary benefits in Project MAINSTREAM: a promising health professions educational model to address global substance abuse. J Interprof Care 2006; 20(6):655-64.

46.

Cleary

Howell

. The educational interaction between physical therapy and occupational therapy students. J Allied Health 2003;32(2):71-7.

47.

Saitz

Sullivan

Samet

. Training community-based clinicians in screening and brief intervention for substance abuse problems: translating evidence into practice. Subst Abuse 2000;21(1):21-31.

48.

Forsetlund

Bjørndal

Rashidian

et al . Continuing education meetings and workshops: effects on professional practice and health care outcomes. Cochrane Database Syst Rev 2009;2(2):CD003030.

49.

Davis

O’Brien

MAT

Freemantle

et al . Impact of formal continuing medical education: do conferences, workshops, rounds and other traditional continuing education activities change physician behaviour or health care outcomes? JAMA 1999;282(9):867-74.

50.

Kahan

Wilson

Wenghofer

et al . Pharmacists’ experiences with dispensing opioids. Can Fam Physician 2011;57(11):e448-e54.

51.

Porath-Waller

Brown

Frigon

. Perceptions among Alberta healthcare professionals of prescription drug misuse. Drug Alcohol Dep 2015;156:e180.