title: Factors influencing pharmacy services in opioid substitution treatment.
abstract: OBJECTIVE
  Heroin dependence is a serious health burden in Australia. Opioid substitution treatment (OST) has been delivered in Australian community pharmacies since 1985. The effectiveness of pharmacy-based OST is evident and the demand is increasing; however, the participation rate of community pharmacies is low, with over 60% non-providers. While previous Australian studies have focused on perspectives of community pharmacists providing the service, the views of non-providers have not yet been explored. This study aimed to further investigate factors influencing pharmacists' participation in provision of OST in the community pharmacy setting in New South Wales, Australia.
  
  
  METHODS
  Semi-structured interviews were conducted with 35 NSW community pharmacists (20 providers, 15 non-providers). Transcripts of interviews were thematically analysed.
  
  
  RESULTS
  Factors influencing non-providers were mainly stigma and fear, the nature of an opt-in scheme, professionals' moral responsibilities, lack of awareness and knowledge, disproportionate distribution of clients and lack of financial support for OST clients. Providers were motivated by positive attitudes, functional relationships with OST clients/stakeholders, professional satisfaction and financial rewards. Recommendations to improve participation in OST services were offered by both groups.
  
  
  CONCLUSIONS
  This study explored views from both OST providers and non-providers, revealing a number of previously undocumented barriers that affect the uptake of OST provision in New South Wales community pharmacies. There were also profound ethical issues raised for consideration. These findings may help inform future policies aimed at encouraging pharmacists' provision of OST, to address the unmet needs of the ever-increasing number of heroin-dependent clients in the community.
authors: Faculty of Pharmacy, The University of Sydney, Sydney, New South Wales, Australia. betty.chaar@sydney.edu.au
authors: Betty B
authors: BB
authors: Chaar
authors: Holly
authors: H
authors: Wang
authors: Carolyn A
authors: CA
authors: Day
authors: Jane R
authors: JR
authors: Hanrahan
authors: Adam R
authors: AR
authors: Winstock
authors: Romano
authors: R
authors: Fois
mesh_terms: D001291:Attitude of Health Personnel; D001315:Australia; D003157:Community Pharmacy Services / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility; D006556:Heroin Dependence / Q000188:drug therapy*; D006801:Humans; D008297:Male; D058850:Opiate Substitution Treatment / Q000706:statistics & numerical data*; D010595:Pharmacists / Q000523:psychology*
keywords: Australian pharmacist; disproportionate distribution of clientele; pharmacy OST service; professionals' moral responsibility; providers' and non-providers' perspective