<p>Screening tools for detecting problematic opioid use and potential application to community pharmacy practice: a review</p>

Abstract

Problematic opioid use, constituted by a myriad of conditions ranging from misuse to use disorders, has continued to receive an increasing amount of attention in recent years resulting from the high use of opioids in the United States coinciding with morbidity and mortality. Deaths from drug overdoses increased by over 11% between 2014 and 2015, which supports the need for identification of problematic opioid use in additional health care settings. One of these settings is community pharmacy. The community pharmacy is a unique health service setting to identify and potentially intervene with patients at risk of or exhibit problematic opioid use. Problematic opioid use can be identified using one of the various screening tools in conjunction with evaluating prescription drug monitoring systems. A total of 12 tools were identified that could be employed in community pharmacy settings for identifying problematic opioid use. This review highlights these tools and strategies for use that can be utilized in the community pharmacy, which should be adapted to individual pharmacy settings and local needs. Future research should assess pharmacy personnel’s knowledge and perceptions of problematic opioid use and associated screening tools and interventions, which tools can be most effectively used in a community pharmacy, workflow needs to implement problematic opioid use screenings, and the impact of pharmacist engagement in problematic opioid use screening on patient clinical outcomes.

Opioid misuse in community pharmacy patients with chronic non‐cancer pain

“…22 Therefore, the early identification of patients with opioid misuse is essential and the POMI might represent an easy-to-use screening tool in community pharmacies because it is quick and brief (six YES/NO questions). 23 Community pharmacists, in coordination with the patient's physician, can contribute to identify patients with opioid misuse. However, the limited time available and the pharmacy physical environment In this study, 45% of patients had a POMI score of ≥2 and among these patients, 16.4% had a POMI score of ≥4.…”

“…Therefore, the early identification of patients with opioid misuse is essential and the POMI might represent an easy‐to‐use screening tool in community pharmacies because it is quick and brief (six YES/NO questions) 23 …”

Opioid Use Disorder: Screening, Diagnosis, and Management

“…Additional screening tools have been validated in various populations, for example, the Mini International Neuropsychiatric Interview (MINI) and the National Institute on Drug Abuse Modified Alcohol, Smoking, and Substance Involvement Screening Test (NMASSIST). 28 As each screening/ diagnostic tool has specific benefits and drawbacks in relation to reliability, validity, and time of administration, it is important to carefully consider the most appropriate choice dependent on the population at hand. Most importantly, any individual diagnosed with an opioid use disorder should be offered and initiated on evidence-based treatment in a timely fashion by either the patient's primary care provider or referral to a practitioner with expertise in addiction medicine.…”

Mobilizing pharmacists to address the opioid crisis: A joint opinion of the ambulatory care and adult medicine practice and research networks of the American College of Clinical Pharmacy

“…Therefore, screening and intervention tools should be developed specific to the needs and resources available to each practice setting. Screening can be completed quickly by pharmacists and other clinical staff and validated tools, such as SBIRT, should be integrated into health records and pharmacy dispensing software for ease of tracking and monitoring 119,120 . Furthermore, although there is a temptation for pharmacists to use PDMP reports for OUD screening, combining these data with validated screening tools is more beneficial for identifying patients at risk for OUD 61,121 .…”