(1257) Barriers and Facilitators of Buprenorphine Dispensing in Appalachian Kentucky: Key Messages from Community Pharmacy Focus Groups

Objectives: The goals of this project are to identify and describe facilitators and barriers to buprenorphine dispensing in community pharmacies in Appalachian Kentucky and to develop key messages focused on increasing buprenorphine dispensing in counties with low dispensing rates relative to the overdose mortality rate.
Understanding facilitators and barriers to buprenorphine dispensing as they are reported by community pharmacists and pharmacy technicians will contribute to the development of educational programs and public health policy initiatives intended to increase access to this life-saving medication. Within the current project, this research will inform an educational outreach campaign designed to modify dispensing behaviors and increase buprenorphine dispensing in Appalachian Kentucky. The results of this study may also help explain recent research showing that a substantial portion of community pharmacies across the country decline to dispense buprenorphine to some or all patients. Understanding the drivers of this behavior may be essential to initiatives focused on increasing access to treatment for opioid use disorder and ending the opioid overdose crisis.

Methods: In this project, multiple focus groups will be used to probe barriers and facilitators to buprenorphine dispensing in Appalachian Kentucky. Pharmacists and pharmacy technicians will be recruited from community pharmacies in 21 counties representing the region’s highest- and lowest- dispensing counties relative to overdose mortality rate. Each focus group will include up to 10 pharmacists and/or pharmacy technicians, with a goal of recruiting at least 75 percent pharmacists in each group. Prompts will be given to elicit discussion of barriers and facilitators of buprenorphine dispensing, and focus group discussions will be recorded and transcribed. Thematic analysis will be conducted using a grounded theory approach.
Pharmacists with experience in educational outreach and academic detailing will use the themes identified by the focus group analysis to develop key messages for community pharmacists. These key messages will be specific behavior-change recommendations supported by evidence that close the gap between actual and ideal pharmacy practice related to buprenorphine treatment. In later stages of this project, these key messages will be deployed in an educational intervention to increase buprenorphine dispensing in low-dispensing Appalachian counties.

Results: Research in progress. Results presented will include focus group analysis and key messages.

Conclusions: Research in progress.