Exploring the opinions of community pharmacists on the implementation of satellite methadone clinics in Malta: a small island state.

Tonna, R.; Tonna, A.; Mifsud, J.; Cruickshank, S.

Abstract

Methadone maintenance treatment (MMT) was introduced in Malta in 1987 and is provided by the Substance Misuse Outpatient Unit (SMOPU), formerly referred to as Detox. Presently Malta’s national drug policy encourages healthcare professionals and service providers to work synergistically at a centralised level, which allows healthcare professionals to refer opioid-dependent users to SMOPU and receive their prescribed methadone dose from this facility. It is to be noted that MMT is free of charge from SMOPU and is currently not available from community pharmacies in Malta. The aim of this research was to assess the opinions and attitudes of community pharmacists regarding the implementation of methadone dispensing within the community setting. This was achieved by developing a cross-sectional survey in the form of a questionnaire. This consisted of mainly Likert scale and close-ended questions, and was distributed to all 191 community pharmacies in Malta. The target population was reasonably small and readily accessible, allowing all community pharmacies in Malta to be included. The cross-sectional questionnaire was first piloted to 20 community pharmacies, followed by the complete distribution and collection from the remaining community pharmacies over a period of eight weeks, starting from January 2019. Questionnaire responses were entered into SPSS version 23 to allow analysis for statistical significance, using graphs and charts to represent collected data. The total number of questionnaires distributed among community pharmacies in Malta amounted to 215. A total of 130 completed questionnaires were returned resulting in a response rate of 60.5% (n = 130). Overall, pharmacists are more willing to dispense buprenorphine rather than methadone with 48.5% of pharmacists willing to dispense buprenorphine. Pharmacists interested in dispensing methadone within the community setting falls to 33.1%. When analysing the role of the community pharmacist in reference to MMT, 54.6% agreed that it is the pharmacist’s role to dispense methadone to drug misusers and 72.3% of the participants felt that pharmacists must be trained specifically in order to do so. However, 30% and 77% of participants responded that MMT should be available through the NHS POYC scheme available in community pharmacies and health centres respectively. If MMT were made available privately within the community setting, 96.2% of participants wish to be reimbursed for their service as extra space or staff may be required to run the service. This study demonstrates that pharmacists in Malta are more willing to supply buprenorphine rather than methadone. Hesitancy to dispensing methadone over buprenorphine arises due to lack of proper training on MMT where buprenorphine requires no such training and deals with fixed doses. Also contributing significantly to this is the lack of education and knowledge of pharmacists on the overall subject of MMT. However, with more commitment to harm reduction, proper education and training may result in an increase in professional confidence as well as an improved attitude and patient service.

Citation

TONNA, R., TONNA, A., MIFSUD, J. and CRUICKSHANK, S. 2020. Exploring the opinions of community pharmacists on the implementation of satellite methadone clinics in Malta: a small island state. Presented at the 2020 Health services research and pharmacy practice conference, 16-17 April 2020, Cardiff, UK.

• Presentation Conference Type: Poster
• Conference Name: Health services research and pharmacy practice conference 2020
• Conference Location: Cardiff, UK
• Start Date: Apr 16, 2020
• End Date: Apr 17, 2020
• Deposit Date: Jul 1, 2020
• Publicly Available Date: Mar 26, 2024
• DOI: https://doi.org/10.1111/ijpp.12607
• Keywords: Pharmacists; Methadone; Opiod abuse treatment; Malta
• Public URL: https://rgu-repository.worktribe.com/output/940746
• Additional Information: Abstract published as:; TONNA, R., TONNA, A., MIFSUD, J. and CRUICKSHANK, S. 2020. Exploring the opinions of community pharmacists on the implementation of satellite methadone clinics in Malta: a small island state. International journal of pharmacy practice [online], 28(S1): abstracts of papers presented at the Health services research and pharmacy practice conference 2020, 16-17 April 2020, Cardiff, UK, page 72. Available from: https://doi.org/10.1111/ijpp.12607