Lifeguard Pharmacy - A feasibility trial of a novel pharmacy-based intervention for people experiencing domestic abuse and/or suicidal ideation.

Abstract Background Domestic abuse (DA) and suicidal ideation (SI) are highly prevalent in the United Kingdom, often co-occurring. Numerous practical and psychosocial barriers inhibit help-seeking. This study explored whether community pharmacy could offer an accessible setting for a DA and SI response service. Methods 12 pharmacies were recruited from one pharmacy organisation, randomised into 8 intervention pharmacies and 4 controls. 37 pharmacy staff were recruited as participants and trained to deliver the Lifeguard Pharmacy intervention, which involved providing a consultation and structured referral or signposting to customers identified as experiencing DA and/or SI. Participants’ learning from the training was evaluated using the validated CPD reaction questionnaire, analysed using a Paired T-Test The intervention ran from January to July 2023 and was accompanied by a nested process evaluation consisting of staff focus groups and a multi-stakeholder final evaluation workshop with a mix of lay, pharmacy staff and representatives from referral organisations. Data was collected on number and category of client contacts from intervention and control pharmacies; descriptive analyses were performed. Results After intervention training, pharmacy staff showed statistically significant improvements in their levels of perceived ability, ease and confidence in responding to and referring people in need of help for DA and SI with increased confidence in the ability of other pharmacy staff to support DA and SI. Staff responded to 24 cases in intervention pharmacies: 8 for suicidal ideation, 9 for domestic abuse and 7 for both domestic abuse and suicidal ideation. Of these, 22 were staff-initiated and two were patient-initiated. Two cases (1 x SI and 1 x DA) were identified in control pharmacies. Staff participants had a positive perception of the service and its impact on them and their clients. The multi-stakeholder workshop findings confirmed the feasibility of a staff-initiated response service for both DA and SI in a community pharmacy setting. Conclusions It is feasible to implement a staff-initiated response service for DA and/or SI in selected pharmacies. The combination of staff training, consultation guide, referral tool and client support resources and organisational support empowered staff to proactively identify people experiencing DA and/or SI.