A Global Survey on Opioid Stewardship Practices in Hospitals: A Cross-Sectional Pilot Study

Al-Samawy, Sarah; Varughese, Nisha; Vaillancourt, Régis; Wang, Xiao Yu William; Penm, Jonathan

doi:10.3390/pharmacy9030122

Cited by 3 publications

(3 citation statements)

References 16 publications

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“…Academic detailing, where prescribers receive noncommercial education from other healthcare professionals (such as pharmacists), can help prescribers stay up-to-date on best opioid prescribing recommendations as supported by current scientific evidence. 44 , 45 Pharmacists can counsel patients on various facets regarding opioid use or misuse. Whether it be MOUD therapy for opioid misuse or opioid therapy for pain, pharmacists can provide biochemical and pharmacological expertise to enable safe usage of opioids.…”

Section: Resultsmentioning

confidence: 99%

The Role of the Pharmacist in Combating the Opioid Crisis: An Update

Kosobuski

O’Donnell

Sharp

et al. 2022

SAR

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The opioid overdose crisis has claimed hundreds of thousands of lives in the United States in the last decade, with overdose numbers continuing to climb. At the same time, the role of the pharmacist in combating the opioid crisis continues to evolve. Methods: A literature search was conducted in Ovid MEDLINE that incorporated both MeSH terms and keywords to describe two concepts: the opioid epidemic and pharmacists/pharmacies. The search was limited to articles published after 2010 through the end of 2021 and returned 196 articles that were analyzed thematically. Results: Thematic analysis revealed the following themes: prevention, interventions, public health role of the pharmacist, pharmacists in multiple roles, barriers, pharmacist and healthcare provider attitudes, educational initiatives for pharmacists and student pharmacists, and future research. Discussion: While a great deal of progress has been made in the role of the pharmacist in supporting individuals with opioid use disorder (OUD) in the last two decades, pharmacists must seek to invest time and resources into practices with a strong evidence base to better mitigate the growing, devastating impact of the opioid crisis. Pharmacists must be willing to embrace new and non-traditional roles in patient care, service and research, and seek to advance evidence-based knowledge and practice. Conclusion: Pharmacy practice has expanded greatly in the past decade with pharmacists taking on new and creative approaches to addressing the opioid crisis. Collaborative and interdisciplinary approaches to addressing the root causes of opioid misuse and opioid overdose are still desperately needed. These include attention to the critical roles of social determinants of health, stigma elimination, legislative advocacy for patients with OUD, and focused education for providers, pharmacists, and the community. Recognition and support of the value of collaboration to both improve public health and individual patient care, continued investments in pharmacy practice advancement in OUD treatment and harm reduction, and the creation of workflows and prescribing algorithms to assist in dosing medications to prevent withdrawal symptoms and achieve improved pain control are desperately needed.

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Section: Resultsmentioning

confidence: 99%

The Role of the Pharmacist in Combating the Opioid Crisis: An Update

Kosobuski

O’Donnell

Sharp

et al. 2022

SAR

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“… 14 Some policies overlook opioid prescribing practices and opioid stewardship around the world, including tailored prescribers’ education. 15 In addition, stewardship programs can incorporate the concept of shared decision-making to promote better utilization of the prescribed opioids among the patient population. 16 However, there is a lack of an established definition and scope of practice referring to opioid stewardship.…”

Section: Introductionmentioning

confidence: 99%

“… 16 However, there is a lack of an established definition and scope of practice referring to opioid stewardship. 15 Considering the varying concept of opioid stewardship, this systematic review aimed to synthesize definitions of “opioid stewardship” proposed by clinical practice guidelines and professional societies and propose a universally acceptable definition.…”

Section: Introductionmentioning

confidence: 99%

What is “Opioid Stewardship”? An Overview of Current Definitions and Proposal for a Universally Acceptable Definition

Shrestha¹,

Khatiwada²,

Sapkota³

et al. 2023

JPR

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Introduction Opioid stewardship has been widely used to promote rational use, monitoring and discontinuation of opioid therapy; however, its definition and scope of practice remain unclear. Objective To synthesize definitions of opioid stewardship proposed by clinical practice guidelines and professional societies, and to offer a proposal for a universally acceptable definition. Methods Systematic literature searches were performed (earliest records to May 2022) in six databases (MEDLINE, EMBASE, APA PsycINFO, Scopus, and CENTRAL) and grey sources guidelines development bodies and professional societies through Google. The conventional but widely applied content analysis and word frequencies were used to analyze the definitions and scope of practice. Results After removing duplicates, 449 articles were retrieved (439 databases and registers and 11 from other sources), 19 of which included a definition of “opioids stewardship”. A total of 12 themes was identified in the definitions, including 1) improvement or appropriateness of prescribing opioids use, 2) mitigation of risk from opioids, 3) monitoring opioid use, 4) evaluation of opioid use, 5) judicious opioid use, 6) appropriateness of opioid disposal, 7) identification and treatment of opioid use disorder, 8) reduction in mortality associated with opioid overdoses, 9) appropriate procurement practices, 10) appropriate storage, 11) promoting better communications between patients and prescribers including education provision and 12) patient-centered decision-making. Conclusion Opioid stewardship is inconsistently defined across professional and research literature. While there is a greater focus on appropriateness and need for improvement of prescribing and monitoring of opioid use, the importance of communications between patients and prescribers, and patient involvement in both prescribing and deprescribing decision-making remains sparse. A comprehensive definition has been proposed as part of the work. There is a need to develop and validate the proposed definition and scope of practice to promote rationale for opioid prescribing, use and attainment of favourable outcomes through international consensus involving practitioners, researchers, and patients.

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Examining clinical pharmacist interventions and identifying opioid medication-related issues in patients with cancer

Anwar,

Malik,

Siddiqui

et al. 2024

J Oncol Pharm Pract

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Introduction Opioid medications are crucial for managing pain among patients with cancer. Yet, inappropriate prescribing and medication issues can compromise patient safety and quality of care. Clinical pharmacists play a significant role in optimizing opioid therapy and addressing issues related to opioid medication use. Objectives This study aimed to examine clinical pharmacist interventions and identify opioid medication-related issues in patients with cancer. Method We conducted a retrospective observational study at Shaukat Khanum Memorial Cancer Hospital and Research Center in Lahore, Pakistan, conducting a chart review from 1st July 2021 to 31st December 2021. Results Out of 10,534 opioid medication orders, we documented a total of 974 interventions based on our inclusion criteria. Tramadol and morphine accounted for most of these interventions, comprising 49.27% (n = 475) and 40.04% (n = 386), respectively. Regarding clinical significance, 41.70% (n = 406) were deemed significant, while 37.36% (n = 365) were somewhat significant. The majority of interventions, i.e., 54.05% (n = 521), primarily aimed at optimizing patient outcomes, followed by a secondary aim of improvements in communication, i.e., 25.52% (n = 246). Conclusion This study establishes the evaluation of clinical pharmacist interventions on opioid medication use in patients with cancer, an issue particularly in oncology settings in Pakistan. The findings emphasize the crucial role of clinical pharmacists in addressing issues related to opioid issue medications, thus improving patient safety and optimizing opioid use for patient well-being.

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A Global Survey on Opioid Stewardship Practices in Hospitals: A Cross-Sectional Pilot Study

Cited by 3 publications

References 16 publications

The Role of the Pharmacist in Combating the Opioid Crisis: An Update

The Role of the Pharmacist in Combating the Opioid Crisis: An Update

What is “Opioid Stewardship”? An Overview of Current Definitions and Proposal for a Universally Acceptable Definition

Examining clinical pharmacist interventions and identifying opioid medication-related issues in patients with cancer

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