(1321) Barriers and Facilitators on the Provision of Fentanyl Test Strips in Pennsylvania Community Pharmacies

Objectives: The objective of this study is to identify barriers and facilitators on the provision of fentanyl test strips in Pennsylvania community pharmacies. Over 109,000 deaths from accidental fentanyl overdose were reported in the United States in 2022, a notable increase from 2021. To reduce the number of preventable overdoses, fentanyl test strips (FTS) can be used to help people who use drugs make informed decisions about their drug supply and use. Fentanyl test strips detect potentially deadly amounts of fentanyl commonly found in illicitly manufactured drugs. Beginning in January 2023, FTS are no longer considered drug paraphernalia in Pennsylvania. This change can allow places such as community pharmacies to offer fentanyl test strips in an accessible environment. Most pharmacies in Pennsylvania do not currently provide fentanyl test strips. Because of this, there is a need to investigate the implementation of fentanyl test strip services in community pharmacies.

Methods: Pennsylvania pharmacists, pharmacy team members, or substance use disorder harm reduction specialists who are 18 years of age and older will be asked to participate in focus group discussions. We will use purposeful maximum variation sampling to strategically select participants that represent various geographic regions, harm reduction experience, and job descriptions who have potentially diverse viewpoints on the qualitative questions. Partnerships with the local health department and a statewide clinically integrated network of community pharmacies will be utilized to identify participants for this research. Four to five 90-minute focus groups will be conducted with 4-7 participants each. Focus groups will be conducted in 2 phases and will be audio-recorded and transcribed verbatim. The first phase will consist of 2-3 homogeneous focus groups of either pharmacists and pharmacy team members or harm reduction specialists. Data from phase 1 focus groups will undergo a rapid qualitative analysis to inform discussion points for phase 2 focus groups. Focus groups in the second phase will include 1-2 additional heterogeneous groups of both pharmacists and harm reduction specialists from phase one to utilize member checking methodology of findings from the first phase and to further brainstorm implementation strategies. Interview questions are informed by the Consolidated Framework for Implementation Research and the National Harm Reduction Coalition's Eight Principles of Harm Reduction. Questions will gather participant opinions regarding fentanyl test strips, stigma associated with harm reduction or drug use, and how harm reduction services can be integrated into pharmacy workflow, including barriers and facilitators. The interview guide was piloted with 4 pharmacy team members prior to deployment. Participants will receive a $75 incentive to participate in this study. This research is funded by an American Pharmacists Association New Practitioner Research Grant and was approved by the University’s IRB.

Results: Research in progress. To date, potential participants have been invited via e-mail regarding focus group participation.

Conclusions: The results of this study will provide insight into the facilitators and barriers to the implementation of fentanyl test strips in Pennsylvania community pharmacies. Harm reduction tools such as fentanyl test strips help prevent avoidable deaths and can be made accessible via community pharmacies. Results from this study will help inform pharmacies nationally about the provision of harm reduction tools, like fentanyl test strips, in community pharmacies. This broad accessibility to harm reduction tools may help reduce drug use-related stigma.