Using the theory of planned behavior to investigate community pharmacists' beliefs regarding engaging patients about prescription drug misuse
Using the theory of planned behavior to investigate community pharmacists' beliefs regarding engaging patients about prescription drug misuse
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DOI：
10.1016/j.sapharm.2018.10.027
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发表时间：
2019-08-01
影响因子：
3.9
通讯作者：
Varisco, Tyler J.
中科院分区：
文献类型：
--
作者：
Fleming, Marc L.;Bapat, Shweta S.;Varisco, Tyler J.
导言：阿片类药物滥用每年导致美国超过5万人死亡。处方药物监测程序（PDMP）数据库是管理已知或潜在阿片类药物使用障碍（OUD）患者的有用决策分析工具。然而，迄今为止，很少有研究试图确定药剂师如何使用PDMPs来吸引潜在OUD患者。目的：通过对PDMP数据的回顾，得出社区药师对患者参与（即提供介入性咨询）疑似管制药物滥用的意愿的模态显著信念。方法：以计划行为理论为理论框架，对德克萨斯州社区药师进行焦点小组调查。开放式问题用于捕获与药剂师参与相关的行为信念、规范信念和控制信念。用ATLAS进行定性分析。Ti软件被用于识别至少20%的研究样本所引出的模态显著信念。结果：共有31名社区药师参与。15个行为信念、13个规范信念和11个控制信念被确定为模态显著信念。最普遍的行为信念是与患者对抗相关的不利因素。药剂师还认为，吸引患者可能会导致客户/业务的损失，但可以帮助患者得到适当的咨询。当被问及他们的规范性信念时，药剂师认为监管机构（如药房委员会、执法部门）和患者的家人/朋友是影响他们转诊意愿的个人群体。咨询所需的时间被发现是最常被引用的控制信念。结论：结果说明了社区药剂师在考虑滥用处方阿片类药物患者参与时面临的一些挑战。解决这些阻碍患者参与的障碍对于提高药剂师与潜在OUD患者接触的意愿至关重要。
Introduction: Opioid misuse causes over 50,000 deaths in America each year. Prescription drug monitoring program (PDMP) databases serve as a useful decision analysis tool in managing patients with known or potential opioid use disorder (OUD). To date, however, little research has sought to determine how pharmacists use PDMPs to engage patients with potential OUD.Objectives: To elicit modal salient beliefs of community pharmacists regarding their willingness to engage patients (i.e., provide interventional counseling) with suspected controlled substance misuse as identified from reviewing PDMP data.Methods: Focus groups were conducted among Texas community pharmacists using the theory of planned behavior as a theoretical framework. Open-ended questions were used to capture behavioral beliefs, normative beliefs and control beliefs associated with pharmacists' engagement. Qualitative analysis using ATLAS.ti software was conducted to identify modal salient beliefs elicited by at least 20% of the study sample.Results: A total of 31 community pharmacists participated. Fifteen behavioral beliefs, thirteen normative beliefs and eleven control beliefs were identified as modal salient beliefs. The most prevalent behavioral belief was the disadvantage associated with patient confrontations. Pharmacists also believed that engaging patients may cause loss of customers/business but may help patients receive appropriate counseling. When asked about their normative beliefs, pharmacists identified regulatory agencies (e.g., pharmacy boards, law enforcement) and family/friends of patients as groups of individuals who influence their willingness to refer. Time required for counseling was found to be the most commonly cited control belief.Conclusion: The results illustrate some of the challenges faced by community pharmacists when considering engagement of patients with misuse of prescription opioids. Addressing these barriers to patient engagement is critical to increasing pharmacists' willingness to engage patients with potential OUD.