Pharmacists at the frontline: a qualitative investigation of the acceptability and feasibility of an ethical framework for preventing opioid-related harm in pharmacy practice

Abstract Objectives To evaluate the acceptability and feasibility of a proposed ethical framework that describes pharmacists’ responsibilities when dispensing opioids. Methods Qualitative methods were used to assess the views of pharmacists regarding the proposed framework. Registered pharmacists in Australia were recruited via online advertising on social media platforms. A mixture of focus groups and semi-structured interviews was conducted, and transcripts were analyzed using thematic analysis to evaluate whether the framework was seen as acceptable and feasible, and whether pharmacists were likely to enact the responsibilities outlined in the framework. Key findings Seventeen pharmacists from both hospital and community pharmacy settings participated across five focus groups and five semi-structured interviews. Four key themes emerged: (i) whether the responsibilities outlined in the framework were obligatory, (ii) whether the framework provided sufficient guidance, (iii) whether—or what—external factors were reasons not to fulfil a certain obligation, and (iv) the relationship between individual professional autonomy and the responsibilities of others. While participants varied in views regarding these themes, the framework was generally viewed as acceptable and feasible. Conclusions Pharmacists generally endorsed the ethical framework and judged the implementation of the framework as feasible, but different views regarding the potential enactment of advice provided in the framework reflected differences in professional identity and perceived control. Future work should test the implementation of the framework in a range of settings and with other stakeholders to address variation in professional identity and optimize harm prevention.