Longitudinal evaluation of pharmacists’ social distance preference and attitudes toward patients with opioid misuse following an educational training program

Abstract

Background: Pharmacist stigma via examination of social distance preference and negative attitudes toward persons who misuse opioids is prevalent and may lower the quality of care provided to patients. Few studies have previously extended beyond the immediate post-intervention period to examine stigma change. Methods: This longitudinal cohort study utilized a pre-survey administered before the training program, a post-survey immediately upon completion of the training program, and a delayed post-survey, administered 12 months after the training program. Co-primary outcomes were changes in social distance scale (SDS) total score from baseline to post-survey and from baseline to 12 months. Secondary outcomes included change in SDS question scores and change in negative attitudes. One hundred eighty-seven of the 1211 eligible pharmacists in the state completed the training. Matched responses of forty-four pharmacists who completed all three surveys were examined. Results: The mean total SDS score was significantly lower in the immediate post-training survey than the pre-training mean (14.75 vs. 16.57, p = .000). The 12 months mean total SDS score was also significantly lower than the pre-training mean (15.32 vs. 16.57, p = .017). Significant changes in negative attitudes from baseline to post-survey and from baseline to 12 months were seen. Conclusion: Stigma reduction components integrated into opioid training decreased pharmacist social distance preference and negative attitudes toward patients who misuse opioids immediately after the training and, most notably, were sustained for 12 months.

Keywords:

• Stigma
• social distance
• opioid
• misuse
• opioid use disorder
• pharmacist

Author contributions

MS and HE conceived of the continuing education and upstream opioid prevention initiative. AW conceived of the idea of measurement of pharmacist stigma within the larger initiative. MS, HE, ES, AW, JS, and OF managed and contributed to the operation of the initiative as well as data collection and analysis. AW took the lead in writing this manuscript. AW, MS, HE, ES, JS, and OF provided critical feedback and contributed to the writing of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the North Dakota Department of Public Health [grant numbers FAR0029570, FAR0031923]; the Alex Stern Family Foundation, Fargo, ND [grant number FAR0029437]; and the Blue Cross and Blue Shield Caring Foundation, Fargo, ND [grant number FAR0029481]. The funding organization had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.