Developing and evaluating a scalable suicide prevention gatekeeper training program for community pharmacy staff

Pharmacists are the most accessible health professional in the United States [5-7] and interact with patients who exhibit suicide warning signs[8]. Our recent work in community (retail) pharmacies showed that 22% of pharmacists and pharmacy technicians knew a patient who died by suicide, 22% had a patient request a lethal dose of medication, and 12% had a patient directly express suicidal ideation [15]. Yet few staff members had the training (7%) or resources (9%) to support suicide prevention efforts, and most (90%) desired additional training. Although several suicide prevention training programs exist for pharmacy staff, they are unlikely to be adopted because they are long and often require in-person attendance [10]. Pharmacy chains have to pay their staff for training time when the training is longer than 10 minutes, thus; there is great need to develop suicide prevention training modules that are less than 10 minutes long to maximize dissemination and uptake in large national chain pharmacies. 

Our goal is to increase the number of community pharmacy staff who complete suicide prevention gatekeeper training. We will accomplish our goal through two specific aims. Aim 1 is to create SAVE-Pharm,  an online pharmacy staff gatekeeper training module that includes 2 lessons that are less than 10 minutes in length. The content of SAVE-Pharm will be guided by our preliminary formative data from pharmacy staff and our 5-member Advisory Board of pharmacists and pharmacy technicians. Aim 2 involves conducting a pilot randomized controlled trial (RCT) to evaluate whether SAVE-Pharm affects outcomes for 150 community pharmacy staff in 30 stores in Western North Carolina. We hypothesize that 3 months after the training, the pharmacists and technicians who were randomized to the experimental group, who will complete the SAVE-Pharm training and an interactive video role play, will be more likely to: (1) ask a patient who exhibits suicide warning signs if they are considering suicide (as assessed via 3 simulated patient scenarios), and (2) exhibit better knowledge of suicide prevention and express greater gatekeeper self-efficacy and gatekeeper preparedness. 

If SAVE-pharm and the video interactive role play are proven effective, then we will work with national continuing education outlets, pharmacy chains, and the North Carolina Board of Pharmacy to broadly disseminate the training and evaluate the long-term impact of SAVE-Pharm on pharmacy staff members’ communication and referral behavior in a large-scale, multi-year RCT.