Role of community pharmacies in relation to HIV prevention and drug misuse: findings from the 1995 national survey in England and Wales

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Abstract
Objectives: To establish activity levels of community (high street) pharmacies in the provision of HIV prevention services to drug misusers and to compare these findings with the levels identified in 1988. Design: Self completion questionnaire (four mailings) to a random 1 in 4 sample of all community pharmacies, stratified by family health services authority. Setting: England and Wales. Subjects: Data provided by pharmacist in charge of the dispensary, on service provision at the pharmacy. Main outcome measures: Quantitative reports of current activity levels for (a) dispensing of controlled drugs to drug misusers, (b) sale of needles and syringes, (c) needle and syringe exchange. Results: 74.8% response rate (1984/2654). In 1995, 50.1% (992/1980) of pharmacies were dispensing controlled drugs (mostly methadone), compared with 23.0% (562/2457) in 1988; 34.5% (677/1962) of pharmacies were selling injecting equipment, compared with 28.0% (676/2434) in 1988; 18.9% (366/1937) were providing a needle exchange service, compared with 3.0% (65/2415) in 1988. Conclusion: Activity levels increased substantially across all three service areas. Increased activity included greater individual activity as well as higher proportions of pharmacies participating. The network of community pharmacies represents an underused point of contact for this Health of the Nation target population. Many communities pharmacies have a role in providing HIV prevention services for injecting drug misusers—such as dispensing controlled drugs on prescription, selling injecting equipment, and operating needle exchange schemes Since 1988 the proportion of pharmacies dispensing prescribed controlled drugs has dou- bled, and the proportion taking part in needle exchange schemes has increased sixfold A large reservoir of untapped potential still exists among community pharmacists The community pharmacist has a high level of contact with often “hard to reach” drug misusers; the potential for maximising such contacts should be explored