PDF(Pubmed)
Abstract：
Pharmacy-based screening and brief interventions (SBI) offer opportunities to identify opioid misuse and opioid safety risks and provide brief interventions that do not overly burden pharmacists. Currently, such interventions are being developed without patient input and in-depth contextual data and insufficient translation into practice. The purpose of this study is to qualitatively explore and compare patient and pharmacist perceptions and needs regarding a pharmacy-based opioid misuse SBI and to identify relevant SBI features and future implementation strategies.
Using the Consolidated Framework for Implementation Research, we conducted semi-structured interviews with 8 patients and 11 pharmacists, to explore needs and barriers to participating in a pharmacy-based SBI. We recruited a purposive sample of English-speaking patients prescribed opioids for chronic or acute pain and pharmacists practicing in varied pharmacies (small independent, large-chain, specialty retail) settings. We used an inductive content analysis approach to analyze patient interview data. Then through a template analysis approach involving comparison of pharmacist and patient themes, we developed strategies for SBI implementation.
Most patient participants were white, older, described living in suburban areas, and were long-term opioid users. We identified template themes related to individual, interpersonal, intervention, and implementation factors and inferred applications for SBI design or potential SBI implementation strategies. We found that patients needed education on opioid safety and general opioid use, regardless of opioid use behaviors. Pharmacists described needing patient-centered training, protocols, and scripts to provide SBI. A short-self-reported screening and brief interventions including counseling, naloxone, and involving prescribers were discussed by both groups.
Through this implementation-focused qualitative study, we identified patient needs such as opioid safety education delivered in a private and convenient format and pharmacist needs including training, workflow integration, protocols, and a time-efficient intervention for effective pharmacy-based SBI. Alternate formats of SBI using digital health technologies may be needed for effective implementation. Our findings can be used to develop patient-centered pharmacy-based SBI that can be implemented within actual pharmacy practice.
Using the Consolidated Framework for Implementation Research, we conducted semi-structured interviews with 8 patients and 11 pharmacists, to explore needs and barriers to participating in a pharmacy-based SBI. We recruited a purposive sample of English-speaking patients prescribed opioids for chronic or acute pain and pharmacists practicing in varied pharmacies (small independent, large-chain, specialty retail) settings. We used an inductive content analysis approach to analyze patient interview data. Then through a template analysis approach involving comparison of pharmacist and patient themes, we developed strategies for SBI implementation.
Most patient participants were white, older, described living in suburban areas, and were long-term opioid users. We identified template themes related to individual, interpersonal, intervention, and implementation factors and inferred applications for SBI design or potential SBI implementation strategies. We found that patients needed education on opioid safety and general opioid use, regardless of opioid use behaviors. Pharmacists described needing patient-centered training, protocols, and scripts to provide SBI. A short-self-reported screening and brief interventions including counseling, naloxone, and involving prescribers were discussed by both groups.
Through this implementation-focused qualitative study, we identified patient needs such as opioid safety education delivered in a private and convenient format and pharmacist needs including training, workflow integration, protocols, and a time-efficient intervention for effective pharmacy-based SBI. Alternate formats of SBI using digital health technologies may be needed for effective implementation. Our findings can be used to develop patient-centered pharmacy-based SBI that can be implemented within actual pharmacy practice.
摘要：
背景：基于药房的筛查和简短干预（SBI）提供了识别阿片类药物滥用和阿片类药物安全风险的机会，并提供了简短的干预措施，不会给药剂师带来过多负担。目前,在没有患者输入和深入的上下文数据以及不足的转化为实践的情况下，正在开发此类干预措施。这项研究的目的是定性地探索和比较患者和药剂师对基于药学的阿片类药物滥用SBI的看法和需求，并确定相关的SBI特征和未来的实施策略。
方法：使用实施研究的合并框架，我们对8名患者和11名药剂师进行了半结构化访谈，探索参与以药学为基础的SBI的需求和障碍。我们招募了一个有目的的样本，其中包括讲英语的患者，这些患者为慢性或急性疼痛开了阿片类药物，并在不同的药房执业（小型独立，大链条,专业零售)设置。我们使用归纳内容分析方法来分析患者访谈数据。然后通过涉及药剂师和患者主题比较的模板分析方法，我们制定了履行机构实施战略。
结果：大多数患者是白人，年长的,描述生活在郊区，是长期的阿片类药物使用者。我们确定了与个人相关的模板主题，人际关系,干预，以及SBI设计或潜在SBI实施策略的实施因素和推断的应用。我们发现患者需要接受阿片类药物安全性和一般阿片类药物使用方面的教育，无论使用阿片类药物的行为。药剂师描述需要以患者为中心的培训，协议,和脚本提供SBI。简短的自我报告筛查和简短的干预措施，包括咨询，纳洛酮,两组都讨论了处方者的参与。
结论：通过这项以实施为重点的定性研究，我们确定了患者的需求，例如以私人和方便的形式提供的阿片类药物安全教育，以及包括培训在内的药剂师需求，工作流集成,协议,以及有效的基于药学的SBI的时间有效干预。为了有效实施，可能需要使用数字健康技术的SBI的替代格式。我们的发现可用于开发以患者为中心的基于药学的SBI，该SBI可在实际药学实践中实施。
方法：使用实施研究的合并框架，我们对8名患者和11名药剂师进行了半结构化访谈，探索参与以药学为基础的SBI的需求和障碍。我们招募了一个有目的的样本，其中包括讲英语的患者，这些患者为慢性或急性疼痛开了阿片类药物，并在不同的药房执业（小型独立，大链条,专业零售)设置。我们使用归纳内容分析方法来分析患者访谈数据。然后通过涉及药剂师和患者主题比较的模板分析方法，我们制定了履行机构实施战略。
结果：大多数患者是白人，年长的,描述生活在郊区，是长期的阿片类药物使用者。我们确定了与个人相关的模板主题，人际关系,干预，以及SBI设计或潜在SBI实施策略的实施因素和推断的应用。我们发现患者需要接受阿片类药物安全性和一般阿片类药物使用方面的教育，无论使用阿片类药物的行为。药剂师描述需要以患者为中心的培训，协议,和脚本提供SBI。简短的自我报告筛查和简短的干预措施，包括咨询，纳洛酮,两组都讨论了处方者的参与。
结论：通过这项以实施为重点的定性研究，我们确定了患者的需求，例如以私人和方便的形式提供的阿片类药物安全教育，以及包括培训在内的药剂师需求，工作流集成,协议,以及有效的基于药学的SBI的时间有效干预。为了有效实施，可能需要使用数字健康技术的SBI的替代格式。我们的发现可用于开发以患者为中心的基于药学的SBI，该SBI可在实际药学实践中实施。
