HIV prevention and drug treatment services for drug misusers: a national study of community pharmacists' attitudes and their involvement in service specific training

Aims. To investigate the attitudes of community pharmacists towards HIV prevention services for drug misusers and the relationship between these and their involvement in service provision. Design. Postal survey of a one in four random sample of community pharmacies (N = 2654) in England and Wales, stratified by Family Health Service Authority, in 1995, using up to four mailshots. Setting. Community pharmacies in England and Wales. Participants, The community pharmacist in charge of the dispensary at the random sample of community pharmacies. Measurements. Information on attitudes and behaviour were collected through self-completion and postal return of structured questionnaires using questions with both category responses and Likert scales. Findings. A 74.8% response rate was achieved. Community pharmacists were positive about their role in HIV prevention and the provision of clean injecting equipment to injecting drug users-positive attitudes that were more evident among those pharmacists already providing these services. However, they had concerns over the effect drug misusers may have on business and indicated a need for more training and for more role support. Only a minority had taken part in training on drug misuse and HIV prevention (34.7% and 21.3%, respectively). Many community pharmacists supported the proposal that there should be extensions of their involvement, to include services such as supervising the consumption of methadone in the pharmacy (38.6%) and collecting used prescribed ampoules from patients (33.8%). Positive relationships were identified between training and attitude, and between attitude and service provision. Changes in attitude responses between this 1995 survey and the earlier 1988 survey are also presented. Conclusions. Recommendations are made for further training and greater communication between prescriber/carer and the community pharmacists, for involvement of community pharmacies in new possible forms of service provision, and for there to be greater attention to the value of role support.