Examining Attitudes and Beliefs that Inhibit Pharmacist Implementation of a Statewide Opioid Harm Reduction Program

BACKGROUND: A statewide opioid risk screening program was introduced to pharmacists to provide them with resources to screen patients who are prescribed an opioid medication. Using opioid risk screening equips pharmacists to deliver education and patient-centered interventions for opioid harm reduction. Nearly 50% of pharmacists that enrolled their pharmacy to participate in this program did not actively implement the program to patients. Little research is dedicated to examining factors which contribute to unsuccessful implementation of pharmacy-centered interventions. This research aims to describe barriers and beliefs which may hinder the ability of pharmacists to integrate innovative practices into existing workflow. OBJECTIVES: Using the theory of planned behavior, determine what attitudes and beliefs contribute to unsuccessful implementation of opioid risk screening. METHODS: A survey was developed within the context of a theoretical framework and distributed to pharmacists who did not successfully implement opioid risk screening 12 month following program inception. Attitude, subjective norm, and perceived behavioral control constructs of the theory of planned behavior were used to identify barriers to opioid risk screening implementation. The responses were analyzed using Mann-Whitney U test, ANOVA, and descriptive statistics. RESULTS: Twenty-three pharmacists consented to participate in this study and 17 pharmacists completed the survey (response rate 74%). Pharmacists indicated positive attitudes toward reducing negative opioid outcomes for patients using opioid medications. Positive subjective norm responses indicated a perception that patients and collaborative healthcare providers would approve of pharmacists using opioid risk screening for patients. The highest proportion of negative responses was observed in the perceived behavioral control construct which included difficulty in offering the screening and unsuccessful integration of past interventions. CONCLUSIONS: These results suggest that perceived behavioral control of pharmacists is the most influential factor in unsuccessful implementation of opioid risk screening.