A survey of Veterans Affairs pharmacists: Naloxone prescribing and perceived barriers

Abstract: Introduction: All Veterans Health Administration (VHA) sites have implemented the Opioid Overdose Education and Naloxone Distribution (OEND) program, which aims to reduce opioid-involved overdose deaths. Objectives: Gaining a better understanding of pharmacists' perspectives toward naloxone is essential to developing effective pharmacy-based naloxone services. This study investigated the perspectives of Veterans Affairs pharmacists toward prescribing naloxone and perceived barriers across multiple sites in the Veterans Integrated Service Network (VISN) 10. Methods: This was a multicenter, voluntary, and anonymous survey sent to pharmacists. Survey items reflecting pharmacists' perspectives were evaluated on a 5-point Likert scale, aggregated according to domain, and adjusted for reverse scoring of select questions. Descriptive statistics were scaled from 1.0 to 5.0, representing least-to-most favorable perspectives. Results: A total of 124 surveys were completed and included in the data analysis. Domain-aggregated adjusted means (standard deviation [SD]) for attitudes/beliefs, comfort, knowledge, fear of consequences, and time and resources were 4.08 (0.91), 3.77 (0.97), 3.64 (1.04), 3.69 (0.86), and 3.07 (1.09), respectively. Pharmacists who reported having formal training on naloxone prescribing or administration reported more favorable perspectives in the domains of comfort (p = 0.001), knowledge (p = 0.002), and time and resources (p = 0.008). Pharmacists who had postgraduate residency training reported more favorable perspectives in the domains of attitudes/beliefs (p = 0.007) and knowledge (p = 0.01). Conclusion: Pharmacists' perspectives toward time and resources are a perceived barrier to naloxone prescribing. More favorable perspectives toward naloxone were detected among pharmacists with training on naloxone and pharmacists with postgraduate residency training.