Lethal means management innovations in community pharmacies: A preimplementation study in 6 states

Area of Science:

• Pharmacy Practice
• Implementation Science
• Public Health

Background:

• Suicide is a leading cause of death in the US, often via intentional overdose.
• Community pharmacists are key stakeholders in lethal means management (LMM).
• Implementation barriers and facilitators for LMM innovations are not well understood.

Purpose of the Study:

• To identify implementation facilitators and barriers for novel lethal means management (LMM) innovations in community pharmacies.

Main Methods:

• Semi-structured interviews with rural community pharmacists across six states.
• Utilized the Consolidated Framework for Implementation Research (CFIR).
• Explored innovative LMM strategies including MTM-SBD, compliance packaging, and staff training.

Main Results:

• Compliance packaging and MTM-SBD were identified as most promising LMM strategies.
• Facilitators include adaptable workflows, trained staff, and potential patient demand.
• Barriers involve lack of MTM protocols, payment codes, and insurance coverage for suicidal behavior disorder (SBD).

Conclusions:

• Rural community pharmacists favor MTM and compliance packaging for suicide risk management.
• Implementation facilitators generally exceed barriers for these strategies.
• Key barriers are limited to the expansion of current payment models to include SBD indication.