Exploration of pharmacist comfort with harm reduction behaviors: Cross-sectional latent class analysis

Abstract

Background: Pharmacists are positioned to play important roles in implementing evidence-based prevention and harm reduction approaches for opioid misuse and related healthcare outcomes such as HIV and hepatitis C. More research is needed to understand how best to facilitate harm reduction practices among pharmacists.

Objectives: This hypothesis-generating study investigated 1) whether subgroups (latent classes) were observable among pharmacists based on self-reported comfort with specific harm reduction behaviors; 2) whether having reported expertise in key content areas was associated with any latent classes that might be identified; and 3) whether comfort and training were associated with actually having dispensed syringes for likely non-prescription drug use.

Methods: This was a statewide census of community managing pharmacists in Arizona conducted from December 2018 to May 2019. Participants reported their degree of comfort with 10 harm reduction behaviors, their expertise (recent continuing education and/or specialization) in selected content areas, and their syringe dispensing behavior. Additional sociodemographic information was also collected. Subgroups related to harm reduction were computed using latent class analysis, and associations between study variables were assessed with Fisher’s Exact Tests.

Results: Data suggested the existence of four latent, comfort-based harm reduction classes: high comfort, moderate comfort, clinical comfort, and opioid prevention only. Reported expertise in pre-exposure prophylaxis for HIV (PrEP) was likely associated with harm reduction class. However, class membership was not associated with reporting having dispensed non-prescription syringes, though the single comfort item for syringe dispensing, by itself, was associated therewith.