Making Community Pharmacies Psychologically Informed Environments: A Feasibility study to improve engagement with people with a drug problem

Catriona Matheson, Health Research Consultancy

This feasibility study will test a new approach to the delivery of care to people with a drug problem (PWDP) in community pharmacy.  PWDP might use pharmacies to a collect prescriptions for opiate replacement treatment (e.g. methadone) as well as other medicines or clean injecting equipment.  We know that pharmacies in Scotland have a lot of experience of providing these services.  We also know that pharmacists generally have positive attitudes towards providing these services.  However there continues to be feedback from PWDP and drug services that people feel stigmatised.  PWDP often have mental health problems and a history of trauma in their lives.  Pharmacists (and other health professionals) may not be aware of this and not trained to support people with these problems.  A method used to overcome this, from homeless services, is training staff to provide a Psychologically Informed Environment (PIE).  A PIE is a space where vulnerable people feel safe and relaxed.  Staff are encouraged to think about how they can provide a therapeutic relationship. Staff are also encouraged to share their ideas so the whole pharmacy can develop a shared way of working. To do this staff need training and support.

The aim of this study is to explore whether it is feasible to train all pharmacy staff in this approach and whether it changes how pharmacy staff manage people with problem drug use.  The project will explore if staff change their personal attitudes towards this group of patients as well as seeing if it affects how they manage other patient groups.   The study will also explore patients’ views of this new model of pharmacy service.

The staff in three pharmacies in NHS Greater Glasgow and Clyde will be trained by a psychologist.  Their attitudes will be measured using a questionnaire before training and three months later.  Focus group discussions with staff will explore if they have changed how they deliver care and the pharmacy environment.  Staff will also be asked if this approach has changed how they care for other patient groups such as those with mental health problems. Interviews will be conducted with some of the patients who use each pharmacy.  Patients interviewed will include a range of male/female, age and length of time they have used that pharmacy. Patients will be asked how they feel about using that pharmacy and if they have noticed any changes in the pharmacy.  A new angle that this project will take is to use peer researchers for patient data collection.  Peer researchers are people who themselves have a history of drug use but are now in recovery.  They work for an organisation called the Scottish Drugs Forum that provides them with training and support.  Involving people with direct experience should help us gain honest feedback from patients.

The findings from this study will help us decide whether this method of training staff in PIE should be tested in a bigger trial.  Findings will be shared through presentations, papers and via social media.

This project ran from 01/11/2019 to 28/02/2021. The final report is available to view here.