Opioid counseling and perceptions about opioids of pharmacy technicians: A mixed-methods study
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Background: Studies on knowledge and perception of opioids focused mainly on pharmacists and physicians but in Dutch primary health care, pharmacy technicians have a major role in counseling patients on medication use. Objective: To investigate how pharmacy technicians counsel patients who are prescribed opioids and which underlying barriers and facilitators determine their counseling behavior. Methods: A mixed-methods study was conducted. Interviews with 18 pharmacy technicians were collected, transcribed, and coded (NVivo). Based on the results, a questionnaire for pharmacy technicians was developed and distributed through social media and the PAM panel of pharmacy technicians. The questions addressed information provision, experiences, and perceptions regarding opioid use by patients. Descriptive analysis was performed, and associations were analyzed by a Chi- square test (p<0.05). Results: 193 respondents were included in the analysis. At first opioid dispense, the majority of pharmacy technicians nearly always discussed the dosage and the common side effects. 44.5% (very) frequently distinguished information provision between opioid use for cancer and non-cancer-related pain. Insufficient knowledge about the indication (41.0%), not wanting to frighten (37.3%), and lacking patient compliance (48.7%) were noticed as barriers to discussing opioid dependence. Although 91.2% of respondents thought discussing opioid dependence with patients is important, only 63.2% frequently discussed opioid dependence at first dispense. Conclusion: About two-thirds of respondents (very) frequently discussed opioid dependence. Pharmacy technicians believed it is important to counsel patients on dependence, but experience barriers including patients not being open to receiving information, not wanting to frighten patients, and no availability of information on indications of the opioid.