A community pharmacy intervention for opioid medication misuse: A pilot randomized clinical trial

Cochran, Gerald; Field, Craig A.; Karp, Jordan F.; Seybert, Amy L.; Chen, Qi; Ringwald, Whitney R.; Hruschak, Valerie; Chickering, Sunita; Kincman, Joelle; Jaber, Amanda; Tarter, Ralph E.

doi:10.1016/j.japh.2018.03.005

Cited by 22 publications

(18 citation statements)

References 44 publications

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“…However, this review identified a lack of research studies especially in community pharmacies. Two pilot trials are currently in progress, 100,101 that are evaluating the role of community pharmacists in opioid safety.…”

Section: Discussionmentioning

confidence: 99%

Role of pharmacists in optimising opioid therapy for chronic non-malignant pain; A systematic review

Iqbal

Knaggs

Anderson

et al. 2022

Research in Social and Administrative Pharmacy

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Section: Discussionmentioning

confidence: 99%

Role of pharmacists in optimising opioid therapy for chronic non-malignant pain; A systematic review

Iqbal

Knaggs

Anderson

et al. 2022

Research in Social and Administrative Pharmacy

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“…A contextual review conducted for the 2016 CDC guideline found data indicating that that physicians frequently lack confidence in their ability to prescribe opioids safely, 227 to predict 228 or identify 229 prescription medication misuse or opioid use disorder, and to discuss these issues with their patients. 229,230 Clinicians reported favorable beliefs and attitudes about effects of opioids on pain and quality of life; however, 231 most considered prescription opioid use disorder to be a significant problem, with many concerned about risks of opioid use disorder and overdose mortality.…”

Section: Contextual Question 1 What Are Clinician and Patient Values And Preferences Related To Opioids And Medication Risks Benefits Andmentioning

confidence: 99%

Systematic Review on Opioid Treatments for Chronic Pain: Surveillance Report 1

Chou¹,

Selph²,

Wagner³

et al. 2022

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Purpose of ReviewTo assess the effectiveness and harms of opioid therapy for chronic noncancer pain, alternative opioid dosing strategies, and risk mitigation strategies Key Messages• Opioids are associated with small improvements versus placebo in pain and function, and increased risk of harms at short-term (1 to <6 months) followup; evidence on long-term effectiveness is very limited, and there is evidence of increased risk of serious harms that appear to be dose dependent. • At short-term followup, evidence showed no differences between opioids versus nonopioid medications in improvement in pain, function, mental health status, sleep, or depression. • Evidence on the effectiveness and harms of alternative opioid dosing strategies and the effects of risk mitigation strategies is lacking, although provision of naloxone to patients might reduce the likelihood of opioid-related emergency department visits, a taper support intervention might improve functional outcomes compared to no taper support, and co-prescription of benzodiazepines and gabapentinoids might increase risk of overdose. • No instrument has been shown to be associated with high accuracy for predicting opioid overdose, addiction, abuse, or misuse. iii This report is based on research conducted by the Pacific Northwest Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. 290-2015-00009-I). The findings and conclusions in this document are those of the authors, who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.

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“…There is also evidence that patients are receptive to brief educational interventions on opioid safety and overdose prevention when delivered by pharmacists in the emergency room [16]. Implementation of SBI type interventions by community pharmacists are only beginning to be described and there are a number of efforts underway examining different models screening and intervention delivered through community pharmacies [17–20]. Resources to assist with referral to treatment are widely available, including the treatment services locator provided by SAMHSA (https://www.samhsa.gov/find-treatment).…”

Section: Pharmacists’ Role In Prescription Opioid Screening Managemementioning

confidence: 99%

“…Within these systems, pharmacists often collaborate with other in the healthcare system to partner with others in the healthcare system to monitor and manage a variety of chronic conditions; screening for signs of OUD and potentially referring patients for treatment is a natural extension of many of these existing clinical duties. Practice models that harness the unique skills and position of community pharmacists to identify and intervene with patients at high-risk for, or unrecognized, OUD have started to emerge [17, 18, 21, 22]. A pilot study by Strand et al [21] describes a pharmacy-based screening tool and algorithm to identify and provide care for individuals who may be at high-risk for misuse and opioid-related harms.…”

Section: Pharmacists’ Role In Prescription Opioid Screening Managemementioning

confidence: 99%

Leveraging the role of community pharmacists in the prevention, surveillance, and treatment of opioid use disorders

Bach

Hartung

2019

Addict Sci Clin Pract

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The global rise in opioid-related harms has impacted the United States severely. Current efforts to manage the opioid crisis have prompted a re-evaluation of many of the existing roles in the healthcare system, in order to maximize their individual effects on reducing opioid-associated morbidity and preventing overdose deaths. As one of the most accessible healthcare professionals in the US, pharmacists are well-positioned to participate in such activities. Historically, US pharmacists have had a limited role in the surveillance and treatment of substance use disorders. This narrative review explores the literature describing novel programs designed to capitalize on the role of the community pharmacist in helping to reduce opioid-related harms, as well as evaluations of existing practices already in place in the US and elsewhere around the world. Specific approaches examined include strategies to facilitate pharmacist monitoring for problematic opioid use, to increase pharmacy-based harm reduction efforts (including naloxone distribution and needle exchange programs), and to involve community pharmacists in the dispensation of opioid agonist therapy (OAT). Each of these activities present a potential means to further engage pharmacists in the identification and treatment of opioid use disorders (OUDs). Through a careful examination of these approaches, we hope that new strategies can be adopted to leverage the unique role of the community pharmacist to help reduce opioid-related harms in the US.

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A community pharmacy intervention for opioid medication misuse: A pilot randomized clinical trial

Cited by 22 publications

References 44 publications

Role of pharmacists in optimising opioid therapy for chronic non-malignant pain; A systematic review

Role of pharmacists in optimising opioid therapy for chronic non-malignant pain; A systematic review

Systematic Review on Opioid Treatments for Chronic Pain: Surveillance Report 1

Leveraging the role of community pharmacists in the prevention, surveillance, and treatment of opioid use disorders

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