National survey identifying community pharmacist preceptors' experience, knowledge, attitudes, and behaviors influencing intent to recommend cannabidiol products.

OBJECTIVES: The primary study objective was to characterize community pharmacist preceptors' experience, clinical and legislative knowledge, attitudes, and behaviors regarding cannabidiol (CBD). The secondary study objective was to identify which of these factors influenced intent to recommend CBD products. METHODS: A 36-item survey was used to collect respondent demographics, experience, knowledge, attitudes, and behaviors regarding CBD. Items assessing attitudes, behaviors, and intent were developed using the Theory of Planned Behavior (TPB). Community pharmacist preceptors for schools of pharmacy across the United States were eligible to complete an electronic survey open for 12 weeks from January to April 2020. Descriptive statistics were used to summarize respondent demographics, experience, knowledge, and TPB constructs. Ordinal logistic regression was used to evaluate which factors influenced intent. RESULTS: The survey was disseminated to an estimated 2242 community pharmacist preceptors and received 295 responses (13.2% response rate). Of the 272 respondents who met eligibility criteria to progress through the survey, the survey was completed in its entirety by 236 respondents (86.8% completion rate). For experience items, most respondents (70.7%) reported receiving previous education on CBD. Almost half (48.4%) reported CBD sales in their pharmacies, whereas 89.1% reported answering clinical questions about CBD. For knowledge items, respondents performed poorly on CBD adverse effect and drug interaction items. Many respondents were not comfortable counseling on (49.0%) or recommending (56.1%) CBD products for patient use. Most (74.5%) believed more research was needed before they would feel comfortable recommending CBD products. Most (57.8%) reported not having reliable CBD resources available in their pharmacies. Subjective norms and previous CBD education or personal research were the only factors found to have direct influences on respondents' intent to recommend CBD products. CONCLUSION: Opportunities exist to fill knowledge gaps, enhance confidence, and provide desired educational resources for community pharmacist preceptors on CBD products.

Indiana community pharmacist preceptors' knowledge and perceptions of medication-assisted treatment.

OBJECTIVES: The study aim was to characterize the Indiana community-based pharmacist preceptors' knowledge and perceptions of medication-assisted treatment (MAT) for opioid use disorder (OUD). The secondary objectives were to explore the desired resources, dispensing concerns, and preceptors' involvement in precepting students. DESIGN: A 38-item survey was used to collect respondent demographics, knowledge, and perceptions of MAT for OUD. Perception questions were developed using the social cognitive theory and were adapted from previously published surveys with investigators' permission. SETTING: Community-based Indiana pharmacist preceptors were eligible to complete an electronic survey in February and March 2019. OUTCOME MEASURES: Descriptive statistics were used to characterize preceptor knowledge and perceptions of MAT for OUD. Desired MAT resources, dispensing concerns, and level of involvement in precepting students were collected. Respondent demographics were collected to characterize the study sample. RESULTS: Of the 116 survey responses, 104 were eligible, and 79 community-based pharmacist preceptors completed the survey, yielding a response rate of 76.0%. For knowledge questions, the overall correct score was 56.2%. Respondents had high correct scores on questions related to medication access. However, respondents either self-identified or performed poorly on the following knowledge items: Food and Drug Administration-approved MAT products for OUD, the need to provide an opioid-free interval before initiating treatment with buprenorphine and naltrexone, pregnancy recommendations, and treatment of severe OUD. Respondents reported positive perceptions on MAT for OUD, but identified concerns regarding diversion and misuse of MAT. Most respondents reported a desire for additional education on different aspects of MAT for OUD. Dispensing concerns and preceptors' involvement with students in MAT ranged from no concern and lack of involvement to many different concerns and full student involvement. CONCLUSION: Opportunities exist to fill identified gaps in knowledge, enhance perceptions, and provide desired continuing education for community-based pharmacist preceptors on MAT for OUD.

Perception of immunizations and vaccine recommendation sources for persons living with HIV compared with persons without HIV.

OBJECTIVES: To measure and compare the perception of immunizations, immunization status, and recommendation sources in persons living with HIV (PLWHs) and persons without HIV and determine a strategy for improving immunization rates by increasing awareness of pharmacy services. DESIGN: A 19-item survey based on the Health Belief Model assessed patients' perceptions and recommendation sources regarding immunization acceptance for specific vaccines: Tdap, pneumococcal, and hepatitis B (HepB). Survey items used a 5-point Likert-type scale assessing participants' perceptions, with questions identifying participants' most trusted sources of immunization information and patient demographics. Survey questions were designed to identify perceived susceptibility and severity of vaccine-preventable illness, barriers, benefits, and self-efficacy regarding immunization acceptance, and sources of patient-trusted immunization information. SETTING AND PARTICIPANTS: Survey recruitment occurred in Indiana and included any patient 18 years of age or older picking up medications at a specialty pharmacy predominantly serving PLWHs or a traditional community chain pharmacy. MAIN OUTCOME MEASURES: Primary outcomes included perceived barriers to immunization acceptance obtained from Likert-type scale questions, patient-reported immunization rates of selected vaccines (Tdap, pneumococcal pneumonia, and HepB), and trusted immunization recommendation sources. Logistic regression was performed to model association between perceived barriers, HIV status, and immunization recommendation sources. RESULTS: A total of 142 participants (68 PLWHs, 74 persons without HIV) completed the survey. PLWHs were more likely to have immunization barriers, but this was not statistically significant (odds ratio 2.537, 95% confidence interval 0.585-10.996). Both participant groups reported "family doctor" as the most trusted source, with only 5% selecting "pharmacist." Significantly fewer PLWHs reported completing the HepB series (18% vs. 52%; P = 0.0224). CONCLUSION: PLWHs possess barriers to immunization acceptance similar to persons without HIV yet report lower rates of HepB vaccine completion. Although pharmacists were less frequently selected as the most trusted source, additional studies on percptions of pharmacists' role in immunizing PLWHs should be considered.