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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Autores principales:	Grace Trull, Erin Major, Chase Harless, William Zule, Bayla Ostrach, Delesha Carpenter
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Buprenorphine Opioid use disorder Pharmacist Access Rural Pharmacy and materia medica RS1-441
Acceso en línea:	https://doaj.org/article/24424d92cecf4477897e7e1fa396545a
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spelling	oai:doaj.org-article:24424d92cecf4477897e7e1fa396545a2021-11-28T04:40:00ZRural community pharmacist willingness to dispense Suboxone® - A secret shopper investigation in South-Central Appalachia2667-276610.1016/j.rcsop.2021.100082https://doaj.org/article/24424d92cecf4477897e7e1fa396545a2021-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2667276621000822https://doaj.org/toc/2667-2766Background: 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.Grace TrullErin MajorChase HarlessWilliam ZuleBayla OstrachDelesha CarpenterElsevierarticleBuprenorphineOpioid use disorderPharmacistAccessRuralPharmacy and materia medicaRS1-441ENExploratory Research in Clinical and Social Pharmacy, Vol 4, Iss , Pp 100082- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Buprenorphine Opioid use disorder Pharmacist Access Rural Pharmacy and materia medica RS1-441
spellingShingle	Buprenorphine Opioid use disorder Pharmacist Access Rural Pharmacy and materia medica RS1-441 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
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.
format	article
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
title	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_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_sort	rural community pharmacist willingness to dispense suboxone® - a secret shopper investigation in south-central appalachia
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/24424d92cecf4477897e7e1fa396545a
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Rural community pharmacist willingness to dispense Suboxone® - A secret shopper investigation in South-Central Appalachia

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