1
|
Gionfriddo MR, Owens KM, Leist SE, Schrum LT, Covvey JR. Attitudes, beliefs, knowledge, and practices for over-the-counter syringe sales in community pharmacies: A systematic review. J Am Pharm Assoc (2003) 2023; 63:1472-1489.e3. [PMID: 37429389 DOI: 10.1016/j.japh.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/02/2023] [Accepted: 07/06/2023] [Indexed: 07/12/2023]
Abstract
BACKGROUND Community pharmacies are an important resource for people who inject drugs (PWID) to purchase over-the-counter (OTC) syringes. Access to sterile injection equipment can reduce the transmission of blood-borne illnesses. However, pharmacists and their staff ultimately use discretion over sales. OBJECTIVE To identify staff attitudes, beliefs, knowledge, and practices in the sale of OTC syringes in community pharmacies. METHODS This systematic review was reported according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and registered with PROSPERO (CRD42022363040). We systematically searched PubMed, Embase, and Scopus from inception to September 2022. The review included peer-reviewed empirical studies regarding OTC syringe sales among community pharmacy staff (pharmacists, interns, and technicians). We screened records and extracted data using a predefined data extraction form. Findings were narratively synthesized, and critical appraisal was conducted using the Mixed Methods Appraisal Tool. RESULTS A total of 1895 potentially relevant articles were identified, and 35 were included. Most studies (23; 63.9%) were cross-sectional descriptive designs. All studies included pharmacists, with seven (19.4%) also including technicians, two (5.6%) including interns, and four (11.1%) including other staff. Studies found relatively high support among respondents for harm reduction-related services within community pharmacies, but less common reports of staff engaging in said services themselves. When studies investigated the perceived positive or negative impacts of OTC syringe sales, prevention of blood-borne illness was widely understood as a benefit, while improper syringe disposal and safety of the pharmacy and its staff commonly reported as concerns. Stigmatizing attitudes/beliefs toward PWID were prevalent across studies. CONCLUSION Community pharmacy staff report knowledge regarding the benefits of OTC syringes, but personal attitudes/beliefs heavily influence decisions to engage in sales. Despite support for various syringe-related harm reduction activities, offerings of services were less likely due to concerns around PWID.
Collapse
|
2
|
Community pharmacist experiences of providing needle and syringe programmes in Ireland. Res Social Adm Pharm 2017; 13:767-777. [DOI: 10.1016/j.sapharm.2016.07.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 06/13/2016] [Accepted: 07/06/2016] [Indexed: 11/21/2022]
|
3
|
Wenger LM, Rosenthal M, Sharpe JP, Waite N. Confronting inequities: A scoping review of the literature on pharmacist practice and health-related disparities. Res Social Adm Pharm 2015; 12:175-217. [PMID: 26119111 DOI: 10.1016/j.sapharm.2015.05.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Revised: 05/22/2015] [Accepted: 05/23/2015] [Indexed: 12/16/2022]
Abstract
BACKGROUND An expanding body of literature is exploring the presence and impact of health and health care disparities among marginalized populations. This research challenges policy makers, health professionals, and scholars to examine how unjust and avoidable inequities are created at the societal, institutional, and individual level, and explore strategies for mitigating challenges. OBJECTIVES Recognizing the significance of this broader conversation, this scoping review provides an overview of pharmacy-specific research attentive to health-related disparities. METHODS Following Arksey and O'Malley's framework, a rigorous screening process yielded 93 peer-reviewed and 23 grey literature articles, each analyzed for core themes. RESULTS Lending critical insight to how pharmacy practice researchers are conceptualizing and measuring health inequities, this review highlights three paths of inquiry evident across this literature, including research focused on what pharmacists know about marginalized groups, how pharmacists perceive these groups, and how they provide services. Striving to drive research and practice forward, this review details research gaps and opportunities, including a need to expand the scope of research and integrate knowledge. CONCLUSIONS As pharmacists endeavor to provide equitable and impactful patient care, it is essential to understand challenges, and build strong evidence for meaningful action.
Collapse
Affiliation(s)
- Lisa M Wenger
- Ontario Pharmacy Research Collaboration (OPEN), School of Pharmacy, University of Waterloo, 10 Victoria St S, Kitchener, ON N2G1C5, Canada.
| | - Meagen Rosenthal
- School of Pharmacy, The University of Mississippi, P.O. Box 1848, University, MS 38677, USA
| | - Jane Pearson Sharpe
- Ontario Pharmacy Research Collaboration (OPEN), School of Pharmacy, University of Waterloo, 10 Victoria St S, Kitchener, ON N2G1C5, Canada
| | - Nancy Waite
- Ontario Pharmacy Research Collaboration (OPEN), School of Pharmacy, University of Waterloo, 10 Victoria St S, Kitchener, ON N2G1C5, Canada
| |
Collapse
|
4
|
Janulis P. Pharmacy nonprescription syringe distribution and HIV/AIDS: a review. J Am Pharm Assoc (2003) 2013; 52:787-97. [PMID: 23229966 DOI: 10.1331/japha.2012.11136] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To summarize current research findings on pharmacy nonprescription syringe distribution to prevent the spread of human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) among injection drug users (IDUs), including research on pharmacist attitudes and behavior, drug user attitudes and behavior, and the health impact on HIV/AIDS risk behavior. DATA SOURCES Data were collected using PubMed and PsycINFO through July 2011. Search terms used were pharmacist or pharmacy and syringe or syringe exchange or needle or needle exchange. Two journals (Journal of Urban Health and Journal of the American Pharmacists Association) with a high number of hits were manually inspected. Reference sections for each article also were examined. STUDY SELECTION Studies were included if they examined attitudes toward, experiences with, or the impact of pharmacy nonprescription syringe distribution for the purpose of preventing the spread of HIV/AIDS among IDUs in the United States. Studies were excluded that mentioned these topics in passing or did not report empirical results. DATA SYNTHESIS 47 studies were identified that met the inclusion criteria. Studies included a diverse range of perspectives, including pharmacist viewpoints, IDU attitudes, and evaluations. CONCLUSION According to the available literature, many pharmacists express willingness to sell and report selling syringes to customers without a prescription. IDUs show willingness to use pharmacies to obtain syringes. Finally, pharmacy syringe sale and the legalization of this practice appear to have a positive impact on HIV risk behavior. Accordingly, the nonprescription sale of syringe should be promoted. However, the literature remains incomplete and future research is required.
Collapse
Affiliation(s)
- Patrick Janulis
- Department of Psychology, Michigan State University, East Lansing, USA.
| |
Collapse
|
5
|
Rivera AV, Blaney S, Crawford ND, White K, Stern RJ, Amesty S, Fuller C. Individual- and neighborhood-level factors associated with nonprescription counseling in pharmacies participating in the New York State Expanded Syringe Access Program. J Am Pharm Assoc (2003) 2011; 50:580-7. [PMID: 20833615 DOI: 10.1331/japha.2010.09202] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To determine the individual- and neighborhood-level predictors of frequent nonprescription in-pharmacy counseling. DESIGN Descriptive, nonexperimental, cross-sectional study. SETTING New York City (NYC) during January 2008 to March 2009. INTERVENTION 130 pharmacies registered in the Expanded Syringe Access Program (ESAP) completed a survey. PARTICIPANTS 477 pharmacists, nonpharmacist owners/managers, and technicians/clerks. MAIN OUTCOME MEASURES Frequent counseling on medical conditions, health insurance, and other products. RESULTS Technicians were less likely than pharmacists to provide frequent counseling on medical conditions or health insurance. Regarding neighborhood-level characteristics, pharmacies in areas of high employment disability were less likely to provide frequent health insurance counseling and pharmacies in areas with higher deprivation were more likely to provide counseling on other products. CONCLUSION ESAP pharmacy staff members are a frequent source of nonprescription counseling for their patients in disadvantaged neighborhoods of NYC. These findings suggest that ESAP pharmacy staff may be amenable to providing relevant counseling services to injection drug users and warrant further investigation.
Collapse
Affiliation(s)
- Alexis V Rivera
- Center for Urban Epidemiologic Studies, New York Academy of Medicine, New York 10029, USA.
| | | | | | | | | | | | | |
Collapse
|
6
|
Crawford ND, Blaney S, Amesty S, Rivera AV, Turner AK, Ompad DC, Fuller CM. Individual- and neighborhood-level characteristics associated with support of in-pharmacy vaccination among ESAP-registered pharmacies: pharmacists' role in reducing racial/ethnic disparities in influenza vaccinations in New York City. J Urban Health 2011; 88:176-85. [PMID: 21279450 PMCID: PMC3042083 DOI: 10.1007/s11524-010-9541-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
New York State (NYS) passed legislation authorizing pharmacists to administer immunizations in 2008. Racial/socioeconomic disparities persist in vaccination rates and vaccine-preventable diseases such as influenza. Many NYS pharmacies participate in the Expanded Syringe Access Program (ESAP), which allows provision of non-prescription syringes to help prevent transmission of HIV, and are uniquely positioned to offer vaccination services to low-income communities. To understand individual and neighborhood characteristics of pharmacy staff support for in-pharmacy vaccination, we combined census tract data with baseline pharmacy data from the Pharmacies as Resources Making Links to Community Services (PHARM-Link) study among ESAP-registered pharmacies. The sample consists of 437 pharmacists, non-pharmacist owners, and technicians enrolled from 103 eligible New York City pharmacies. Using multilevel analysis, pharmacy staff who expressed support of in-pharmacy vaccination services were 69% more likely to support in-pharmacy HIV testing services (OR, 1.69; 95% CI 1.39-2.04). While pharmacy staff who worked in neighborhoods with a high percent of minority residents were less likely to express support of in-pharmacy vaccination, those in neighborhoods with a high percent of foreign-born residents were marginally more likely to express support of in-pharmacy vaccination. While educational campaigns around the importance of vaccination access may be needed among some pharmacy staff and minority community residents, we have provided evidence supporting scale-up of vaccination efforts in pharmacies located in foreign-born/immigrant communities which has potential to reduce disparities in vaccination rates and preventable influenza-related mortality.
Collapse
Affiliation(s)
- Natalie D Crawford
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
| | | | | | | | | | | | | |
Collapse
|
7
|
Zaller N, Jeronimo A, Bratberg J, Case P, Rich JD. Pharmacist and pharmacy staff experiences with non-prescription (NP) sale of syringes and attitudes toward providing HIV prevention services for injection drug users (IDUs) in Providence, RI. J Urban Health 2010; 87:942-53. [PMID: 21116724 PMCID: PMC3005095 DOI: 10.1007/s11524-010-9503-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Increased access to sterile syringes among injection drug users (IDUs) has been correlated with reduced syringe sharing. Many states, including Rhode Island, have legalized non-prescription (NP) sale of syringes in pharmacies. Previous studies have suggested that training pharmacists to provide HIV-related services to IDUs may be an important opportunity to engage IDUs and provide them with such services. However, it is not clear to what extent pharmacy staff are willing to expand their roles in providing services to IDUs who come in to purchase syringes. We recruited pharmacists and pharmacy staff from the 48 pharmacies indicating NP sale of syringes in the greater Providence, RI area, to participate in an online survey consisting of demographic information; views about the current syringe laws in Rhode Island; willingness to provide HIV-related services, including referral for HIV testing, substance use treatment, and medical and social services, to IDUs; and past experiences with IDU customers. One hundred and forty-six individuals completed the online survey (32 pharmacies, 114 pharmacy staff). Most participants were employed by chain pharmacies (92%). Most participants thought that pharmacies are important resources for IDU customers (77%) and that they would be willing to provide health and prevention information/referrals to IDU customers who purchase NP syringes (59%). With respect to willingness to offer HIV prevention-related services, access to confidential space and concern about personal safety had the strongest associations with willingness to provide HIV prevention services (OR, 4.3 and 0.1, respectively). As the nature of the retail pharmacy shifts, researchers, pharmacy executives, and health care officials can build upon the willingness of pharmacists and pharmacy staff in order to address the health needs of injection drug users and other underserved populations.
Collapse
Affiliation(s)
- Nickolas Zaller
- Division of Infectious Diseases, The Miriam Hospital, 164 Summit Ave., CFAR Building, Providence, RI, 02906, USA.
| | | | | | | | | |
Collapse
|
8
|
Cooper EN, Dodson C, Stopka TJ, Riley ED, Garfein RS, Bluthenthal RN. Pharmacy participation in non-prescription syringe sales in Los Angeles and San Francisco counties, 2007. J Urban Health 2010; 87:543-52. [PMID: 20549568 PMCID: PMC2900565 DOI: 10.1007/s11524-010-9483-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Increasing sterile syringe access for injection drug users (IDUs) is one way to prevent HIV and hepatitis C virus (HCV) transmission in this population. In 2005, California Senate Bill 1159 allowed counties to adopt the Disease Prevention Demonstration Project (DPDP). Where enacted, the DPDP allows pharmacies that register with the county to sell up to ten syringes to adults without a prescription. In the current study, we describe pharmacy participation in nonprescription syringe sales (NPSS) in two counties in California and examine factors associated with NPSS. Telephone and in-person interviews were conducted in Los Angeles (LA) and San Francisco (SF) with 238 pharmacies in 2007 (n = 67 in SF; n = 171 in LA). Quantitative survey items captured pharmacy registration with the county, pharmacy policies/practices, episodes and conditions of NPSS and refusals to sell, potential negative consequences of NPSS, and staff attitudes regarding HIV and HCV prevention for IDUs. Overall, 42% of pharmacies reported NPSS (28% in LA and 81% in SF), although only 34% had registered with the county (17% in LA and 76% in SF). Many pharmacies required proof of a medical condition (80% in LA and 30% in SF) and refused NPSS if the customer was a suspected IDU (74% in LA, 33% in SF). Few negative consequences of NPSS were reported. In multivariate logistic regression analysis, we found that the odds of NPSS were significantly higher among pharmacists who thought syringe access was important for preventing HIV among IDUs [adjusted odds ratio (AOR) = 2.95; 95% confidence interval (CI) = 1.10-7.92], were chain pharmacies (AOR = 12.5; 95% CI = 4.55-33.33), and were located in SF (AOR = 4.88; 95% CI = 1.94-12.28). These results suggest that NPSS were influenced by pharmacists' perception. NPSS might be increased through greater educational efforts directed at pharmacists, particularly those in non-chain pharmacies.
Collapse
Affiliation(s)
- Erin N Cooper
- Urban Community Research Center, Sociology Department, California State University Dominguez Hills, 1000 East Victoria Street, Carson, CA 90747, USA
| | | | | | | | | | | |
Collapse
|
9
|
Tesoriero JM, Battles HB, Klein SJ, Kaufman E, Birkhead GS. Expanding access to sterile syringes through pharmacies: Assessment of New York's Expanded Syringe Access Program. J Am Pharm Assoc (2003) 2009; 49:407-16. [DOI: 10.1331/japha.2009.07127] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
10
|
Weiss L, Gany F, Rosenfeld P, Carrasquillo O, Sharif I, Behar E, Ambizas E, Patel P, Schwartz L, Mangione R. Access to multilingual medication instructions at New York City pharmacies. J Urban Health 2007; 84:742-54. [PMID: 17926130 PMCID: PMC2232041 DOI: 10.1007/s11524-007-9221-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
An essential component of quality care for limited English proficient (LEP) patients is language access. Linguistically accessible medication instructions are particularly important, given the serious consequences of error and patient responsibility for managing often complex medication regimens on their own. Approximately 21 million people in the U.S. were LEP at the time of the 2000 census, representing a 50% increase since 1990. Little information is available on their access to comprehensible medication instructions. In an effort to address this knowledge gap, we conducted a telephone survey of 200 randomly selected NYC pharmacies. The primary focus of the survey was translation need, capacity, and practice. The majority of pharmacists reported that they had LEP patients daily (88.0%) and had the capacity to translate prescription labels (79.5%). Among pharmacies serving LEP patients on a daily basis, just 38.6% translated labels daily; 22.7% never translated. In multivariate analysis, pharmacy type (OR = 4.08, 95%CI = 1.55-10.74, independent versus chain pharmacies) and proportion of Spanish-speaking LEP persons in the pharmacy's census tract (OR = 1.09, 95%CI = 1.05-1.13 for each 1% increase in Spanish LEP population) were associated with increased label translation. Although 88.5% of the pharmacies had bilingual staff, less than half were pharmacists or pharmacy interns and thus qualified to provide medication counseling. More than 80% of the pharmacies surveyed lacked systematic methods for identifying linguistic needs and for informing patients of translation capabilities. Consistent with efforts to improve language access in other health care settings, the critical gap in language appropriate pharmacy services must be addressed to meet the needs of the nation's large and ever-growing immigrant communities. Pharmacists may require supplemental training on the need and resources for meeting the verbal and written language requirements of their LEP patients. Dispensing software with accurate translation capability and telephonic interpretation services should be utilized in pharmacies serving LEP patients. Pharmacists should post signs and make other efforts to inform patients about the language resources available to them.
Collapse
Affiliation(s)
- Linda Weiss
- Center for Urban Epidemiologic Studies, New York Academy of Medicine, New York, USA.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
11
|
Fuller CM, Galea S, Caceres W, Blaney S, Sisco S, Vlahov D. Multilevel community-based intervention to increase access to sterile syringes among injection drug users through pharmacy sales in New York City. Am J Public Health 2006; 97:117-24. [PMID: 17138929 PMCID: PMC1716247 DOI: 10.2105/ajph.2005.069591] [Citation(s) in RCA: 145] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Research has indicated that there is minimal use of pharmacies among injection drug users (IDUs) in specific neighborhoods and among Black and Hispanic IDUs. We developed a community-based participatory research partnership to determine whether a multilevel intervention would increase sterile syringe access through a new policy allowing nonprescription syringe sales in pharmacies. METHODS We targeted Harlem, NY (using the South Bronx for comparison), and disseminated informational material at community forums, pharmacist training programs, and counseling or outreach programs for IDUs. We compared cross-sectional samples in 3 target populations (pre- and postintervention): community members (attitudes and opinions), pharmacists (opinions and practices), and IDUs (risk behaviors). RESULTS Among community members (N = 1496) and pharmacists (N = 131), negative opinions of IDU syringe sales decreased in Harlem whereas there was either no change or an increase in negative opinions in the comparison community. Although pharmacy use by IDUs (N=728) increased in both communities, pharmacy use increased significantly among Black IDUs in Harlem, but not in the comparison community; syringe reuse significantly decreased in Harlem, but not in the comparison community. CONCLUSIONS Targeting the individual and the social environment through a multilevel community-based intervention reduced high-risk behavior, particularly among Black IDUs.
Collapse
Affiliation(s)
- Crystal M Fuller
- Harlem Community & Academic Partnership at the Center for Urban Epidemiological Studies, New York Academy of Medicine, New York, NY, USA.
| | | | | | | | | | | |
Collapse
|
12
|
Golub ET, Bareta JC, Mehta SH, McCall LD, Vlahov D, Strathdee SA. Correlates of unsafe syringe acquisition and disposal among injection drug users in Baltimore, Maryland. Subst Use Misuse 2005; 40:1751-64. [PMID: 16419554 DOI: 10.1080/10826080500259513] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Because multi-person syringe use is the most common vehicle for HIV and hepatitis C virus transmission among injection drug users (IDUs), safe sources of sterile syringes and safe methods of disposal are necessary to curb these epidemics. We examined syringe acquisition and disposal in a cohort of IDUs in Baltimore. Between January 1, 1998 and December 31, 2001, 1034 participants reported on syringe acquisition at 3492 visits, and 953 reported on disposal at 2569 visits. Participants were 69.9% male, 93.9% African-American, and median age was 44. Syringes were acquired exclusively from unsafe sources at 32.3% of visits, while exclusively unsafe disposal was reported at 59.3% of visits. Significant correlates of unsafe acquisition were: attending shooting galleries, anonymous sex, sharing needles, smoking crack, and emergency room visits. Significant correlates of unsafe disposal were: injecting speedball, no methadone treatment, acquiring safely, and frequent injection. Having a primary source of medical care was associated with safe acquisition, but unsafe disposal. IDUs continue to acquire safely but dispose unsafely, especially among those with a primary source of care; this suggests that messages about safe disposal are not being disseminated as widely as those about acquisition. These data suggest the need for a more active program involving pharmacists, an expanded syringe access program, and better efforts to enhance safe disposal.
Collapse
Affiliation(s)
- Elizabeth T Golub
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | | | | | | | | | | |
Collapse
|
13
|
Compton WM, Horton JC, Cottler LB, Booth R, Leukefeld CG, Singer M, Cunningham-Williams R, Reich W, Fortuin Corsi K, Staton M, Fink JL, Stopka TJ, Spitznagel EL. A multistate trial of pharmacy syringe purchase. J Urban Health 2004; 81:661-70. [PMID: 15466847 PMCID: PMC3455919 DOI: 10.1093/jurban/jth149] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Pharmacies are a potential site for access to sterile syringes as a means for preventing human immunodeficiency virus (HIV), but the type and extent of their utility is uncertain. To examine pharmacy syringe purchase, we conducted a standardized, multistate study in urban and rural areas of four states in which attempts to purchase syringes were documented. Of 1,600 overall purchase attempts, 35% were refused. Colorado (25%) and Connecticut (28%) had significantly lower rates of refusal than Kentucky (41%) and Missouri (47%). Furthermore, urban settings had higher rates of refusal (40%) than rural settings (31%, P < .01). Race and gender did not have a consistent impact on rates of refusal. Despite potential advantages of pharmacies as sites for access to sterile syringes, pharmacy purchase of syringes faces significant obstacles in terms of the practices in different jurisdictions.
Collapse
Affiliation(s)
- Wilson M Compton
- National Institute on Drug Abuse, 6001 Executive Boulevard, MSC 9589, Bethesda, MD 20892-9589, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Finkelstein R, Tiger R, Greenwald R, Mukherjee R. Pharmacy syringe sale practices during the first year of expanded syringe availability in New York City (2001-2002). JOURNAL OF THE AMERICAN PHARMACEUTICAL ASSOCIATION (WASHINGTON, D.C. : 1996) 2002; 42:S83-7. [PMID: 12489622 DOI: 10.1331/1086-5802.42.0.s83.finkelstein] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE [corrected] To assess the role that customer characteristics, including race, age, and gender and pharmacy characteristics, including type and location, play on actual syringe-selling practice by pharmacies registered to sell syringes under the New York State Expanded Syringe Access Demonstration Program (ESAP). DESIGN 89 syringe-purchasing visits were made in randomly selected ESAP-registered pharmacies, stratified by chain and independent status. SETTING Visits were conducted in 14 New York City neighborhoods. Three neighborhoods (two with high need for human immunodeficiency virus [HIV] prevention services and one with low need) were selected in each of New York City's five boroughs (except Staten Island, where only two neighborhoods were visited, as only one exists with high need for HIV prevention services). PARTICIPANTS Visits were conducted by syringe-purchasing testers with different demographic characteristics, including age (< or = 25 and > 25), race/ethnicity (white, black, Latino), and gender (men, women). RESULTS Testers were able to purchase syringes in 69% of visits. Tester race, age, and gender did not significantly affect sales of syringe-selling practices. Location of pharmacy was statistically significant, with only 33% of the registered pharmacies selling syringes in the Bronx, but 67% to 89% selling in other four boroughs. CONCLUSIONS ESAP has been widely implemented among registered pharmacies in four of New York City's five boroughs. The program's effectiveness could be enhanced through pharmacy-based efforts focused broadly on the ESAP goal of preventing the transmission of HIV and other blood-borne infections among injection drug users.
Collapse
Affiliation(s)
- Ruth Finkelstein
- Office of Special Populations, The New York Academy of Medicine, New York City 10029, USA.
| | | | | | | |
Collapse
|
15
|
Jones TS, Coffin PO. Preventing blood-borne infections through pharmacy syringe sales and safe community syringe disposal. JOURNAL OF THE AMERICAN PHARMACEUTICAL ASSOCIATION (WASHINGTON, D.C. : 1996) 2002; 42:S6-9. [PMID: 12489602 DOI: 10.1331/1086-5802.42.0.s6.jones] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- T Stephen Jones
- Division of HIV/AIDS Prevention, Intervention, Research, and Support, National Center for HIV, STD & TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
| | | |
Collapse
|
16
|
Taussig J, Junge B, Burris S, Jones TS, Sterk CE. Individual and structural influences shaping pharmacists' decisions to sell syringes to injection drug users in Atlanta, Georgia. JOURNAL OF THE AMERICAN PHARMACEUTICAL ASSOCIATION (WASHINGTON, D.C. : 1996) 2002; 42:S40-5. [PMID: 12489614 DOI: 10.1331/1086-5802.42.0.s40.taussig] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To better understand the individual (e.g., attitudes and beliefs) and structural (e.g., laws and regulations) factors that influence and shape pharmacists' decisions about selling syringes to injection drug users (IDUs). DESIGN Qualitative research. SETTING Metropolitan Atlanta. PARICIPANTS: 20 practicing pharmacists who work in or near areas of high drug use in Atlanta, and nine pharmacists who are considered leaders in their profession in Georgia. INTERVENTIONS Semistructured, in-depth interviews. MAIN OUTCOME MEASURES Individual and structural factors that influence pharmacists' decisions about selling syringes to IDUs. RESULTS Pharmacists reported that they use their professional discretion in making syringe sale decisions and that these decisions are influenced by individuals factors such as their personal attitudes and beliefs about the nature and causes of drug use, and by structural factors such as the Georgia Board of Pharmacy regulation stating that syringes cannot be sold if they will be used for an "unlawful purpose." CONCLUSIONS IDUs' access to sterile syringes from pharmacies in Atlanta, would likely be increased by (1) providing practicing pharmacists with professional education programs that describe the broad professional support for IDU access to sterile syringes and why blood-borne infection prevention is a legitimate medical purpose for selling syringes and (2) removing or modifying the restrictive Board of Pharmacy regulation governing syringe sales.
Collapse
|