Community pharmacy staff interactions with patients who have risk factors or warning signs of suicide.

BACKGROUND: Little is known about community pharmacy staff members' interactions with patients at risk of suicide. OBJECTIVES: To: 1) develop a measure to assess the frequency with which pharmacy staff encounter patients with suicide risk factors and warning signs; 2) to assess the measure's validity and reliability; and 3) describe pharmacy staff members' interactions with at-risk patients and their suicide prevention training preferences. METHODS: A convenience sample of 501 community pharmacy staff members who worked in North Carolina completed an anonymous online survey. A 10-item measure (the Pharmacy Suicide Interaction Scale (PSIS)) assessed how often respondents encountered patients with suicide risk factors or warning signs, and one open-ended question elicited barriers to interacting with these patients. Psychometric analyses, including an exploratory factor analysis, were performed to examine the validity and reliability of the PSIS. Descriptive statistics were calculated, and responses to open-ended questions were analyzed thematically. RESULTS: The PSIS possessed two factors (or subscales): a non-verbal suicide warning signs and risk factors subscale (Cronbach's alpha = 0.79) and a verbal warning signs subscale (Cronbach's alpha = 0.67). Respondents who knew a patient who had died by suicide had higher mean scores on the non-verbal and verbal subscales, indicating that the PSIS had construct validity. Many respondents (22.4%) knew a patient who died by suicide, and 21.6% of respondents had patients request a lethal dose of medication. Interactions occurred both face-to-face and over the phone, and respondents most commonly reacted to patients by contacting others or offering emotional support. Few respondents (8.8%) had suicide prevention training or resources, but most (89.6%) desired additional training. CONCLUSION: Many community pharmacy staff members have interacted with patients who exhibited suicide warning signs or died by suicide. Suicide prevention training may help prepare pharmacy staff to recognize, communicate with, and refer at-risk patients.

Factors associated with how often community pharmacists offer and dispense naloxone.

BACKGROUND: A recent Surgeon General's report encourages people to ask pharmacists about naloxone, but whether pharmacists are well-prepared to respond to these requests is unclear. OBJECTIVES: Determine factors that are associated with how often pharmacists offer and dispense naloxone. METHODS: A convenience sample of 457 community pharmacists in North Carolina completed a 5-min online survey. Linear regressions were conducted to identify factors that are associated with how often pharmacists offer and dispense naloxone. Pharmacists' self-reported barriers to teaching naloxone administration were identified. RESULTS: Most pharmacists (81.2%) worked in pharmacies that stocked naloxone, but many never offered (36.6%) or dispensed (19.4%) naloxone. Pharmacists offered (ß = 0.15, p < 0.01) and dispensed (ß = 0.15, p < 0.01) naloxone more often when their pharmacy stocked more naloxone formulations. Pharmacists who were more comfortable discussing naloxone offered it more often (ß = 0.26, p = 0.001). Pharmacists who worked in regional/local/grocery chain pharmacies dispensed and offered naloxone less often than other pharmacy types. Barriers to teaching naloxone administration included: time constraints, inadequate training, and perceived lack of patient comprehension. CONCLUSIONS: Many community pharmacists do not offer or dispense naloxone. Pharmacists who are uncomfortable discussing naloxone or work at smaller chain pharmacies may benefit from targeted naloxone training.