title: Prescription Opioid Misuse Among Rural Community Pharmacy Patients: Pilot Study for Screening and Implications for Future Practice and Research.
abstract: BACKGROUND
  Opioid misuse imposes a disproportionately heavy burden on individuals living in rural areas. Community pharmacy has the potential to expand and coordinate with health professionals to identify and intervene with those who misuse opioids.
  
  
  OBJECTIVE
  Rural and urban community pharmacy patients were recruited in this pilot project to describe and compare patterns of opioid misuse.
  
  
  METHODS
  We administered a health screening survey in 4 community pharmacies among patients filling opioid medications. Univariate statistics were used to assess differences in health characteristics and opioid medication misuse behaviors between rural and urban respondents. Multivariable statistics were used to identify risk factors associated with rural and urban opioid misuse.
  
  
  RESULTS
  A total of 333 participants completed the survey. Participants in rural settings had poorer overall health, higher pain levels, lower education, and a higher rate of unemployment compared to patients in urban pharmacies. Rural respondents with illicit drug use (adjustable odds ratio [aOR]: 14.34, 95% confidence interval [CI] = 2.16-95.38), posttraumatic stress disorder (aOR: 5.44, 95% CI = 1.52-19.50), and ≤high school education (aOR: 6.68, 95% CI = 1.06-42.21) had increased risk for opioid misuse.
  
  
  CONCLUSIONS
  Community pharmacy represents a promising resource for potential identification of opioid misuse, particularly in rural communities. Continued research must extend these findings and work to establish collaborative services in rural settings.
authors.affiliation: 1 Department of Psychiatry, School of Medicine, University of Pittsburgh School of Social Work, Pittsburgh, PA, USA.
authors.forename: Gerald T
authors.initials: GT
authors.lastname: Cochran
authors.affiliation: 2 University of Pittsburgh School of Social Work, Pittsburgh, PA, USA.
authors.forename: Rafael J
authors.initials: RJ
authors.lastname: Engel
authors.affiliation: 2 University of Pittsburgh School of Social Work, Pittsburgh, PA, USA.
authors.forename: Valerie J
authors.initials: VJ
authors.lastname: Hruschak
authors.affiliation: 3 University of Pittsburgh School of Pharmacy, Pittsburgh, PA, USA.
authors.forename: Ralph E
authors.initials: RE
authors.lastname: Tarter
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000009:adverse effects*; D035843:Biomedical Research / Q000191:economics / Q000639:trends; D003157:Community Pharmacy Services / Q000191:economics / Q000639:trends*; D004522:Educational Status; D005260:Female; D005544:Forecasting; D006306:Health Surveys / Q000191:economics / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology; D010414:Pennsylvania / Q000453:epidemiology; D010595:Pharmacists / Q000639:trends; D010865:Pilot Projects; D063487:Prescription Drug Misuse / Q000191:economics / Q000639:trends*; D012307:Risk Factors; D012424:Rural Population / Q000639:trends*; D012923:Social Class; D014505:Urban Population / Q000639:trends
chemical_list: D000701:Analgesics, Opioid
keywords: access to care; drug abuse; pharmacy