Pharmacists' Perceptions Regarding Feasibility, Acceptability, and Usefulness of Student-Delivered Naloxone Education Services in Community Pharmacy: A Mixed Methods Study in Alabama.

BACKGROUND: Given that Alabama has the highest opioid prescribing rate in the nation, efforts to promote safe opioid use and reduce overdose mortality are critical. To address this, the Auburn University Harrison College of Pharmacy (HCOP) developed and piloted a didactic-experiential naloxone learning model in the first-year PharmD curriculum in 2020-2021 consisting of lectures, skills laboratory, and 120-hour community pharmacy introductory pharmacy practice experience (IPPE). Student-delivered naloxone education services (SDNES), including naloxone counseling and dispensing, were incorporated into the IPPE.

OBJECTIVES: The objective of this study was to evaluate the feasibility, acceptability, and usefulness of SDNES from the perspective of community pharmacy IPPE preceptors.

METHODS: This study utilized a mixed methods design including cross-sectional online surveys and follow-up semi-structured telephone interviews. Survey measures were informed by Weiner et al (2017) and included feasibility (11-items), acceptability (13-items), and usefulness (6-items) of SDNES. Survey outcomes were assessed via 5-point Likert-type scales (1=strongly disagree, 5=strongly agree) and analyzed using descriptive statistics. Follow-up semi-structured telephone interview questions were guided by the Consolidated Framework for Implementation Research (CFIR) domains of inner and outer setting, and focused on SDNES barriers/facilitators, recommended strategies for service enhancement, and resource needs. Interview transcripts were analyzed using deductive and inductive rapid content analysis to determine themes and sub-themes.

RESULTS: Twenty-five preceptor surveys were completed (22.52% response rate). Overall, SDNES was rated as feasible (mean[SD] scale score: 4.04[0.77]), acceptable (3.95[0.83]), and useful (3.87[0.98]). Interviewees (N=8) discussed 13 barrier sub-themes, 12 facilitator sub-themes, 7 recommended strategies, and 8 resource needs across 3 overarching themes, most of which were related to the inner setting.

CONCLUSION: Community pharmacy IPPE preceptors found SDNES feasible, acceptable, and useful in their practices. The SDNES model may be used to build capacity for naloxone services delivery in community pharmacies, potentially increasing patient access to naloxone education and distribution.