Year of Publication

2013

College

Martin School of Public Policy and Administration

Degree Name

Master of Public Administration

Executive Summary

Methamphetamine is a drug of abuse, which is often produced in clandestine laboratories. Recent efforts to curb methamphetamine abuse are aimed at controlling access to precursors, including pseudoephedrine (PSE), used in illicit methamphetamine production. Currently, access to PSE is controlled in Kentucky by placement behind pharmacy counters, retail quantity limitations and electronic tracking. Recent legislation proposed in Kentucky to change PSE from non-prescription to a legend medication was unsuccessful and highly controversial. The objective of this project is to collect and analyze pharmacists’ opinions on the effectiveness of current precursor controls, proposed legislation to make PSE a legend drug and impact on their practice and patients.

This research has been approved by the University of Kentucky Institutional Review Board and utilizes survey methodology to obtain opinions of Kentucky pharmacists regarding the recent proposed legislation to make PSE a legend drug. Survey questions included perceived efficacy of current precursor controls, anticipated impact on individual pharmacy practice and patients and current opinion in regards to the proposed legislation. For this project, all surveys were conducted anonymously with no identifying information collected. A simple random sample of pharmacists (n=2000) was drawn from a list of all licensed pharmacists in the Commonwealth of Kentucky, excluding pharmacists with an out-of-state practice address. The survey response rate was 30.6%. Pharmacists practicing in a hospital or “other” setting were excluded from the analysis, as their practice sites are not directly impacted by PSE sales. The final group for analysis included 431 pharmacists practicing in a chain or independent community pharmacy setting.

This research has been approved by the University of Kentucky Institutional Review Board and utilizes survey methodology to obtain opinions of Kentucky pharmacists regarding the recent proposed legislation to make PSE a legend drug. Survey questions included perceived efficacy of current precursor controls, anticipated impact on individual pharmacy practice and patients and current opinion in regards to the proposed legislation. For this project, all surveys were conducted anonymously with no identifying information collected. A simple random sample of pharmacists (n=2000) was drawn from a list of all licensed pharmacists in the Commonwealth of Kentucky, excluding pharmacists with an out-of-state practice address. The survey response rate was 30.6%. Pharmacists practicing in a hospital or “other” setting were excluded from the analysis, as their practice sites are not directly impacted by PSE sales. The final group for analysis included 431 pharmacists practicing in a chain or independent community pharmacy setting.

The 2012 Pseudoephedrine Survey for Pharmacists showed that 56.2% of Kentucky pharmacists practicing in a community pharmacy support the proposed legislation to make PSE available by prescription-only, 30.7% oppose the legislation and 13.1% are unsure. Furthermore, independent and chain pharmacists significantly differ in the average number of prescriptions filled per day, number of PSE purchases per day and the number of years in practice. Practice site significantly impacts support for the proposed legislation with chain pharmacists being 2.90 times more likely to support the legislation to make PSE prescription-only. One possible explanation for this difference is that independent pharmacists may exhibit more autonomy in the decision making process to sell or not sell PSE to potential customers. Additional factors that influence pharmacist support of the legislation include: anticipated impact of making PSE prescription-only on time spent on PSE-related activities and pharmacy profits, Kentucky region of pharmacy practice, and anticipated impact of making PSE prescription-only on methamphetamine abuse and laboratory incidents. Kentucky region of pharmacy practice appears to have a large impact on pharmacist support of the legislation. Regions, such as 4 western, eastern, and southern Kentucky, associated more strongly with methamphetamine appear to more strongly support the proposed legislation.

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