Pharmacists' attitudes, knowledge, utilization, and outcomes involving prescription drug monitoring programs: A brief scoping review.

OBJECTIVE: While literature on pharmacists' engagement with prescription drug monitoring programs (PDMPs) is growing, no formal synthesis of findings has been conducted to provide overarching recommendations for research or practice. The objective of this study was to identify and synthesize findings from current literature on community pharmacists' attitudes toward, knowledge of, and registration and utilization behaviors regarding PDMPs. DATA SOURCES: Electronic databases (MEDLINE, PsychINFO, Cochrane Database of Systematic Reviews, Google Scholar, and the Brandeis University PDMP Center of Excellence) and reference lists from relevant manuscripts were searched for relevant English-language manuscripts. Key words used in searches included pharmacist, prescription drug monitoring program, opioid safety, attitudes, knowledge, and utilization. STUDY SELECTION: Papers were included from January 1, 2008 up to October 6, 2017. Three authors independently screened articles for full text review; 2 authors independently conducted full text review for final study selection. Discrepancies were resolved through consensus. DATA EXTRACTION: Data were extracted to an evidence table, coded by topic category, and checked for accuracy. RESULTS: Fifteen manuscripts met inclusion criteria. The studies varied greatly in methodological approach. In general, pharmacists' attitudes and knowledge of PDMPs positively influenced likelihood to register and use their state's program. Targeted training had a substantial impact on knowledge, registration, and utilization. CONCLUSION: Pharmacist-targeted PDMPs and opioid safety training is highly recommended to increase knowledge of and insight into behavioral change.

Proximal Predictors of Alcohol Use among Japanese College Students.

BACKGROUND AND OBJECTIVES: This study investigated how negative social interactions (e.g., disagreeing with a friend) predicted subsequent drinking behaviors among Japanese college students. Because of social influences on drinking, and cultural norms for maintaining social harmony and making amends in response to social transgressions in Japanese culture, the authors hypothesized that students would consume more alcohol socially following increases in negative social interactions. Drinking refusal self-efficacy and social self-efficacy were also studied as moderators of social drinking. METHODS: Fifty-five college students (79% women) of legal drinking age completed a once-daily Internet survey for 30 days, providing 1195 daily reports of drinking and social interaction. Prior to the daily survey, participants reported on Drinking Refusal Self-Efficacy and Social Self-Efficacy in an initial Internet-based assessment. RESULTS: Students drank more socially in the evening following daytime increases in negative social interactions, relative to evenings following fewer such exchanges (b = .23, p < .001). At the between-person level, students who reported stronger confidence in refusing to drink drank less socially compared to those who reported less confidence in drinking refusal (b = -.53, p < .001). Yet, those with higher social self-efficacy, which is typically a health-protective factor, drank more socially compared to their counterparts (b = .32, p < .05). Conclusions and Importance: Japanese college students increased their social drinking in response to daily negative social interactions, consistent with the notion that this drinking pattern represents efforts to make amends to others. Interventions targeted toward increasing students' confidence in refusing to drink may be beneficial in reducing social drinking in this population.

Drinking Motives and Alcohol Use: The SERVe Study of U.S. Current and Former Service Members.

OBJECTIVE: Hazardous drinking in the armed forces is a significant problem. Alcohol use motivations, known risk factors for problem drinking, have been underexplored in this population. Our study extends knowledge about drinking motives among current and former U.S. service members and provides recommendations on their utility in identifying alcohol-related problems by examining the factor structure of multidimensional drinking motives and their association to alcohol use. METHOD: Post-9/11 separated service members and current reservists were recruited from 35 Oregon employers to participate in a workplace study of supervisor support. The resulting sample (N = 509; 84% male; mean age = 39) completed a baseline assessment, which included a comprehensive drinking motives assessment. RESULTS: Drinkers comprised 88% of the sample, with a mean Alcohol Use Disorders Identification Test (AUDIT) score of 5.4 (SD = 4.6); 23.9% scored 8 or more. The four-factor structure of the Drinking Motives Questionnaire-Revised, short form (DMQ-R-SF) was affirmed through confirmatory factor analysis. Internal drinking motives related to enhancement (positive) and coping (negative) were most predictive of alcohol use; coping motives were uniquely predictive of alcohol-related problems, when drinking quantity/frequency, as well as psychological distress, were controlled for. Coping motives also mediate the relationship between psychological distress and AUDIT scores. Results thus demonstrated the generalizability of the DMQ-R-SF motives measure for use with separated service members and reservists. CONCLUSIONS: Drinking motives, assessed by the DMQ-R-SF, represent reliable and important predictors of drinking and associated problems among service members. Inclusion of motivated drinking questions may enhance screening for alcohol-related problems among current and former service members.

Pharmacists' Role in Opioid Safety: A Focus Group Investigation.

Objective: The pharmacist's role and responsibilities in addressing the opioid epidemic have yet to be clearly defined, particularly from the patient's point of view. This qualitative study explores the pharmacist's role in promoting opioid safety from the perspective of pharmacists and patients. Design: Focus groups. Setting: Patient groups were held in person, and pharmacist groups were held online. Subjects: Oregon pharmacists (N = 19, Mage = 39.0 years, range = 26-57 years, 58% female) and patients (N = 18, Mage = 60.1 years, range = 30-77 years, 71% female) with current experience dispensing or receiving opioid medications. Methods: Pharmacists were asked about the challenges and opportunities for opioid safety monitoring and prescription dispensing. Patients were asked about their experiences accessing care, medications, and safety information. Focus group data were analyzed by a multidisciplinary team using an immersion-crystallization approach. Results: Pharmacists and patients agreed that pharmacists are responsible for medication safety. Pharmacists expressed discomfort filling potentially high-risk opioid prescriptions and noted barriers such as lack of clinical information and discomfort policing high-risk prescribing. Patients were concerned about pharmacists potentially overstepping their professional responsibilities by interfering with prescribers' clinical decisions. Conclusions: Feedback from both pharmacists and patient participants suggests that there is uncertainty in the degree to which pharmacists can and should confront the prescription opioid epidemic directly. Ambiguities in the pharmacist's role may be best clarified through structured training promoting enhanced between-party communication.