Compliance to the Syringe Purchase Program and Syringe Disposal Awareness Yolo County

Pharmacies

Ahmed IbrahimSheila Allen PhD, RN

County of Yolo Health DepartmentHIV/AIDS Program

Background

Senate Bill 1159-Effective 2005-2010

1. Permit to sell up to 10 syringes/needles without a prescription2. Over eighteen years of age 3. Pharmacies-register in the Disease Prevention Demonstration Project.

(DPDP)

AB 1305-Effective September 2008

1. Illegal to dispose of needles, syringes or other sharps in municipal trash or sewage system.

Injection Drug Users are a high risk group for HIV and HCV infection

1. Sharing needles is a major risk factor for blood-borne infections 2. Syringe exchange programs and syringe purchase programs aim to provide sterile

syringes and risk education to injection drug users.

Project Objectives

All Pharmacies in Yolo County

Maintained Participation Ended Participation

Risk factorsAccess to Syringes/information

Access to syringes

Attitudes/Beliefs

Syringe Disposal Resources

Pharmacist Consumer

Results: Pharmacy Participation

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Ph

arm

ac

ies

Participation in SB1159

May-05

May-08

67%

33%

Ended Participation

Pharmacies opened later

Non-participant Status

1. 50% decrease in participation due mainly to pharmacy drop out.

2. Newly established pharmacies never contacted for participation

Risk Factor OR P-value

By City

Pharmacies in Davis 1.6 0.691

Pharmacies in West Sacramento 0.93 0.951

Pharmacies in Woodland 0.14 0.0675

By Franchise

Rite Aid Pharmacies 0.39 0.466

Longs Pharmacies 0.25 0.266

Non-branch pharmacies 0.50 0.617

Employee-related

Change in management since recruitment 0.60 0.623

Results: Investigating Risk FactorsCrude Odds Ratio

Univariate Logistic Regression Variables in the Equation

1.611 3 .657

1.792 1.472 1.482 1 .224 6.000 .335 107.420

-21.203 40192.970 .000 1 1.000 .000 .000 .

.405 1.354 .090 1 .765 1.500 .106 21.312

.000 1.000 .000 1 1.000 1.000

CityCode

CityCode(1)

CityCode(2)

CityCode(3)

Constant

Step1

a

B S.E. Wald df Sig. Exp(B) Lower Upper

95.0% C.I.for EXP(B)

Variable(s) entered on step 1: CityCode.a.

17%

17%

33%

33%

Not Aware of Program

Concerned about Syringe Disposal

No literature available to supplement syringes

Directed to do so by corporate headquarters

Results: Attitudes and Beliefs of Non-participating Pharmacy on SB 1159

100% of all respondents agreed to resume participation if their specific concern was addressed.

R2 0.9456

P-value (95% CI) 0.0276

Correlation suggests access of needles at pharmacies to IDU’s

CRIME DATA TAKEN FROM THE UNITED STATES DEPARTMENT OF JUSTICE, BUREAU OF JUSTICE STATISTICS

Drug Related Arrests in 2005 vs. Average Annual Syringe Purchases

0

50

100

150

200

250

300

0 50 100 150 200 250Drug Related Arrests in Yolo County

Syr

ing

e P

urc

has

es (

pac

ks/y

ear)

Prevalence of Informational material on drug rehabilitation and/or proper syringe disposal per non-prescription syringe purchase

78%

22%

No information passed out

Information passed out

Clients of Syringe Purchase Program Have little access to information.

Conclusions

Strengths

Threats

Opportunities

Weaknesses Population size: Too small for meaningful stat analysis. No systematic method for investigating possible risk factors.

Pharmacist attitudes are supportive Pharmacy concerns are addressable

SB 1159 expires in 2010 Understaffing and budget cuts Syringe disposal remains a major concern

100% compliance Pilot study guiding future assessments

AcknowledgementsCounty of Yolo Health DepartmentCounty of Yolo Health Department Sheila Allen PhD, RN Jason Spitzer

Thomas Stopka, MHS Sherif Ali, DVM, MPVM

UC Davis School of Public Health/Veterinary MedicineUC Davis School of Public Health/Veterinary Medicine Dr. Stephen McCurdy (Director) Dr. Christian Sandrock (Advisor) UC Davis Faculty Amber Carrere

Colleagues Colleagues MPH Class 2008 MPVM Class 2008 Epidemiology Graduate Group Comparative Pathology Group Nutrition Masters Group