(1182) A Brief Suicide Prevention Training Improves Community Pharmacists’ Knowledge, Self-efficacy, Communication, and Referral Behavior

Objectives: National and international pharmacy organizations are increasingly recognizing the important role that pharmacists have in preventing suicide. The vast majority of pharmacy staff have not received suicide prevention training; therefore, it is imperative to evaluate training programs specific to pharmacy environments and focused on increasing the skills and abilities of pharmacy staff as gatekeepers. In suicide prevention, gatekeepers from healthcare and the community recognize suicide warning signs and refer at-risk individuals to resources. Our objective is to determine whether a brief suicide prevention gatekeeper training program tailored to community pharmacies (Pharm-SAVES) improves participants’ suicide prevention knowledge, gatekeeper self-efficacy, gatekeeper preparedness, and responses to a hypothetical patient case.

Methods: A convenience sample of practicing community pharmacists and pharmacy technicians (N=120) was recruited from four southeastern states. After verifying eligibility, participants completed a baseline survey and were randomized to either the control (Pharm-SAVES) or intervention group (Pharm-SAVES Plus). Pharm-SAVES Plus had two interactive video cases integrated into the training. Both trainings recommend the use of the National Suicide Prevention Lifeline (988) for referrals. Immediately after completing the online training, participants completed a post-training survey. Both the baseline and post-training survey assessed suicide prevention knowledge, gatekeeper self-efficacy, and gatekeeper preparedness. Surveys also included a written case that asked participants how they would respond to a hypothetical patient with suicide warning signs. Case responses were independently coded by two coders who were blinded to both the time of the assessment (baseline or post-training) and study group assignment. Coders specifically documented whether participants directly asked about suicide and referred patients to 988 in their responses. Consensus was reached on all coded responses. Descriptive statistics were calculated and independent samples paired t-tests and chi-square tests, as appropriate, were used to assess differences between completers and non-completers (alpha=0.05). Generalized Estimating Equations (GEE) were used to examine whether scores on the outcomes of interest varied over time (baseline, post-training) and by intervention group (Pharm-SAVES, Pharm-SAVES Plus).

Results: Of the 120 enrolled participants, 87 completed the immediate post-training survey (completion rate = 73%). Participants who were older, male, and pharmacists were more likely to complete the post-training survey. Neither the intervention group nor the intervention group X time interaction term was significant in any of the GEE models. However, significant improvements by time were observed for each of the four outcomes of interest (p < 0.01). Specifically, suicide prevention knowledge increased from 5.5 at baseline to 7.2 post-training (maximum score = 9). Gatekeeper self-efficacy increased from 2.7 at baseline to 3.7 at post-training (maximum score = 5). Gatekeeper preparedness increased from 3.2 at baseline to 5.3 at post-training (maximum score = 7). The percentage of participants who directly asked about suicide in their written case response increased significantly from 7% at baseline to 71% at post-training. Additionally, the number of participants who stated they would refer the hypothetical patient to the NSPL significantly increased from 54% at baseline to 74% post-training.

Conclusions: Both Pharm-SAVES and Pharm-SAVES Plus increased participants’ suicide prevention knowledge, gatekeeper self-efficacy, gatekeeper preparedness, and responses to patient cases, including communication and referral behaviors. Additional studies are needed to determine whether pharmacy staff have applied Pharm-SAVES training in their practice. Additionally, future work should explore why the interactive video cases in Pharm-SAVES Plus did not further enhance the positive effects of the training.