Role of New Zealand Community Pharmacists in Opioid Substitution Treatment

Abstract

Introduction: Opioid dependence is a chronic relapsing health condition affecting thousands of New Zealanders. Opioid Substitution Treatment (OST), dispensed regularly by community pharmacists (CPs), is a well-recognised evidence-based strategy in reducing the burden of illicit opioid use. People receiving OST are a vulnerable population who experience significant health inequities and stigma, but have regular interactions with CPs. In recent years the role of a CP has evolved, with many CPs now working collaboratively with other health providers to ensure effective and safe use of medicines, as well as being involved in the prevention and management of chronic health conditions.

Aim: To explore the role of New Zealand CPs in the provision of OST.

Methods: Semi-structured video interviews with a purposive sample of 13 CPs from diverse locations around NZ explored CPs’ current practices in providing OST, barriers and facilitators to OST service provision, and CPs’ perceived role within the OST team. Interviews were audio-recorded and transcribed verbatim. Data were coded and analysed using an inductive thematic approach.

Results: Analysis of the data suggests proactive CPs are providing additional health services, advocacy and support as well as dispensing OST, and that there can be an important relationship between people receiving OST and their CP. Collaboration with the OST team and a positive relationship with clients were identified as important facilitators for CPs to provide a quality OST service. Challenges with communication and perceived personal and professional risks were potential barriers to a more effective service.

Conclusion: CPs are well-placed to provide accessible primary health care and this study has shown CPs are able to provide additional healthcare to a vulnerable population with known barriers to accessing healthcare. CPs have regular contact with people receiving OST and can offer valuable insight into clients’ mental and physical wellbeing, but are not always able to work collaboratively with the wider OST team. Increased resourcing and improved communication channels with other healthcare providers could allow CPs to better support people receiving OST on their recovery journey.