Psychometric Properties of the Drug Stigma Scale Among Community Pharmacists Concerning Individuals Who Use Over-The-Counter Drugs

Abstract

Aim: Stigma among pharmacists toward individuals who use over-the-counter (OTC) drugs for unintended purposes may hinder effective support. This study aimed to assess the psychometric properties of the Drug Stigma Scale (DSS) when applied to pharmacists and to examine the factors associated with stigma levels in this context.

Methods: A survey was anonymously distributed to pharmacists attending voluntary online workshops organized by a prefectural pharmaceutical association in Japan from August 2023 to March 2024. These workshops focused on OTC drug use for unintended purposes and the gatekeeping role of pharmacists. A total of 490 responses were analyzed. The DSS, originally a 24-item scale developed for the Japanese context, was adapted to specify "OTC drug use." Confirmatory factor analysis (CFA) and internal consistency analyses were conducted. Concurrent validity was assessed using correlations and group comparisons based on demographic variables, confidence in knowledge, and gatekeeper self-efficacy (GKSES).

Results: The adapted 18-item structure of the DSS demonstrated a good model fit (CFI = 0.93, TLI = 0.91, GFI = 0.92, RMSEA = 0.061). Internal consistency ranged between α = 0.68 and 0.88. Female pharmacists scored significantly lower on several subscales than male pharmacists, indicating less stigmatizing attitudes. Additionally, lower DSS scores were observed among pharmacists who had frequent contact with individuals who misuse OTC drugs, had a family history of such misuse, or sought help for related issues. The correlations between the DSS and GKSES scores were weak but significant.

Conclusion: The DSS is a valid tool for measuring stigma among pharmacists concerning OTC drug use. The findings suggest that direct or familial experiences with OTC drug misuse may reduce stigmatized attitudes. Efforts to reduce stigma should extend beyond knowledge-based interventions and consider community engagement and opportunities for pharmacists to hear individuals' lived experiences.

Keywords: drug stigma scale; over‐the‐counter drugs; pharmacist; stigma.