The effect of an interprofessional pain service on nonmalignant pain control

Coffey, Cory P; Ulbrich, Timothy R.; Baughman, Kristin R.; Awad, Magdi

doi:10.1093/ajhp/zxy084

Cited by 12 publications

(23 citation statements)

References 8 publications

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“…In the 51 studies included in the scoping review, pharmacists developed, led [37][38][39][40][41][42][43][44][45][46][47][48][49][50] and were part of interdisciplinary teams 47,[51][52][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67] and physician collaborative care models 45,48,[68][69][70][71][72][73][74] in the management of opioids. The pharmacists undertaking these roles were embedded in prescribers' location of practice [40][41][42][43][44]46,[55][56][57]…”

Section: Resultsmentioning

confidence: 99%

“…general or family medicine practice and primary care clinics, 37-39,41-46, 49,51-60,65,66,68-76,83,84 healthcare organisations with a range of primary care settings, 47,48,[61][62][63][64]67,79 community pharmacy practices 77,78,85 and outreach services. 50,[80][81][82]86,87 The primary care settings, countries of origin and context of the studies are detailed in Table 2.…”

Section: Resultsmentioning

confidence: 99%

“…38,40,51,53,55,56,61,63,67,74,76,82 For comparative studies, the opioid load was most often estimated by converting it to the oral morphine equivalent daily dose, or oMED, a method to standardise the dose based on the knowledge that different opioids with varying potency may produce a similar analgesic effect. 88 Additional outcomes included the impact of any change to oMED or pharmacist involvement on symptom scores and functionality, 47,48,52,57,69 which were also outcomes for the four palliative care studies. 49,65,66,84 One study only investigated opioid specifically for acute pain and that was in a free dental clinic where the outcome was the change in rates of opioid prescribing.…”

Section: Resultsmentioning

confidence: 99%

“…73 Other quantitative outcomes were retention rates in pharmacist programs, 39,68,70 discontinuation of regular opioids, 77 initiation of pharmacist care plans, 40,51 procurement of take-home naloxone, 38,39,43,50,55,81 change of long-acting opioid formulation, 67 effect on overdose occurrence or premature deaths 39,62 and emergency department presentations. 55 For medical and nurse prescriber participants, the outcomes were any impact as assessed by acceptance rates of pharmacist or multidisciplinary committee recommendations 37,40,42,47,54,59,60,63,67,72,75,78,80,85 as well as measures of prescriber behaviour change, such as adherence to pain management protocols, initiation of nonopioids, prescriptions for take-home naloxone, referrals to external providers, reduced concomitant prescribing with benzodiazepines, engagement of patients in prescriber-patient opioid agreements, prescription monitoring, urine toxicology screening and other measures to assess patient aberrant behaviours, 37,38,40,41,51,[53][54][55]60,62,…”

Section: Resultsmentioning

confidence: 99%

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Opioid medicines management in primary care settings: A scoping review of quantitative studies of pharmacist activities

Jordan

Latif

Mullan

et al. 2021

Brit J Clinical Pharma

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To undertake a scoping review of pharmacist activities in opioid medicines management in primary care settings, including those developed or led by pharmacists, or in which pharmacists were members of broader multidisciplinary teams, and to collate the activities, models of care and settings, and reported outcomes. The bibliographic databases MEDLINE, EMBASE, International Pharmaceutical Abstracts, CINAHL, SCOPUS and Web of Science were searched. Studies with quantitative evaluation and published in English were eligible. Participants were patients with any pain category or an opioid use disorder, and healthcare providers. Studies originating in hospitals or involving supply functions were not included. Screening of literature and data charting of results were undertaken by two researchers. The 51 studies included in the scoping review occurred in primary care settings collated into four categories: general practice or primary care clinics, healthcare organisations, community pharmacies and outreach services. Studies were primarily of opioid use in chronic, noncancer pain. Other indications were opioid use disorder, cancer and dental pain. Pharmacist activities targeted risk mitigation, patient and provider education and broader, strategic approaches. Patient-related outcomes included reduced opioid load, improved functionality and symptom management, enhanced access to services and medication-assisted treatments, and engagement in risk-mitigation strategies. Behaviour change of providers was demonstrated. The review has identified the significant contribution that pharmacists working in primary care settings can make to minimise harm from opioids. Strategies implemented in isolation have the potential to further reduce adverse clinical outcomes with greater collaboration and coordination, such as opioid stewardship.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Opioid medicines management in primary care settings: A scoping review of quantitative studies of pharmacist activities

Jordan

Latif

Mullan

et al. 2021

Brit J Clinical Pharma

View full text Add to dashboard Cite

show abstract

“… 15 The involvement of pharmacists resulted in a decrease in the mean pain score in an underserved population. 34 The pharmacist was responsible for providing interprofessional education to all members of the interprofessional healthcare team. 18 However, some patients’ therapy was deliberately stopped without confirmation by the interprofessional care team.…”

Section: Shared Decision Makingmentioning

confidence: 99%

Role of Pharmacists in the Interprofessional Care Team for Patients with Chronic Diseases

Rahayu¹,

Widianto²,

Defi³

et al. 2021

JMDH

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Chronic diseases are a major health problem and cause of death worldwide. Patients with chronic diseases should be managed by an interprofessional care team consisting of general practitioners, medical specialists, nurses, and pharmacists. However, the roles of pharmacists in this interprofessional care team have not been fully explored. This study, therefore, examined their roles as members of the interprofessional care team in managing patients with chronic diseases. A search in PubMed, Google Scholar, EBSCO, Scopus, and Cochrane Library databases was conducted for research articles that discussed pharmacists, interprofessional healthcare, and chronic diseases. From initial 420 identified articles, a total of 27 articles were included in this study. The interprofessional healthcare team should have a sense of tolerance and belonging among its members, which is reflected in five dimensions: partnership, coordination, cooperation, decision-making, and therapeutic outcomes. The five dimensions are closely related because they support each other in the success of the therapy. The presence of pharmacists in an interprofessional healthcare team has been proven to help facilitate access to primary care and improve patient outcomes. Pharmacists can assist in managing chronic disease conditions by providing drug information to patients and other healthcare providers and by acting as a consultant for treatment-related issues. The pharmacist's role as part of an interprofessional care team reinforces the importance of a collaborative healthcare team in providing clinical services to patients with chronic diseases.

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Pharmacist interventions in an outpatient pain clinic at a Veterans Affairs Medical Center

Voll

Brooks

Vartan

et al. 2021

J Am Coll Clin Pharm

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Purpose: Clinical pharmacist practitioners (CPPs) ensure safe and evidence-based pharmacotherapy practices. However, there is little information to date characterizing the impact of pain CPP interventions on patient outcomes within a CPP-managed outpatient chronic and postoperative pain clinic. The primary objective of this study was to classify and quantify the number of pain CPP interventions in the outpatient pain clinic at the West Palm Beach Veteran Affairs Medical Center (WPB VAMC). The secondary objective assessed general patient outcomes associated with pain pharmacotherapy management by a CPP. Summary: A retrospective chart review of pain CPP encounters was utilized to identify interventions over a 12-month period. A total of 805 pain management encounters with a total of 1993 interventions were recorded by pain CPPs during that time. Descriptive statistics and sample size calculations were used to summarize and evaluate results. Overall, 55% of interventions were pharmacological, 45% were nonpharmacological interventions, and 5% were referrals to other specialty providers.For the secondary objective (n = 107), patients in the pain clinic on opioid therapy experienced an average oral morphine equivalent daily dose (MEDD) reduction of 21 mg without any identified suicide or overdose events and achieved on average 45% of their SMART goals by their last visit. In patients with baseline pain, enjoyment of life, and general activity (PEG) scores (n = 69), there were 43% of patients with improved PEG scores at their last visit in which 14% (10/69) experienced a clinically meaningful improvement in PEG scores. Conclusion:Pain CPPs demonstrated a reduction in overall MEDDs safely while following the biopsychosocial approach to pain management by incorporating and referring for nonpharmacological interventions as well as completing opioid risk mitigation. Additional studies are needed to better characterize pain CPP impact on patient outcomes.

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The effect of an interprofessional pain service on nonmalignant pain control

Cited by 12 publications

References 8 publications

Opioid medicines management in primary care settings: A scoping review of quantitative studies of pharmacist activities

Opioid medicines management in primary care settings: A scoping review of quantitative studies of pharmacist activities

Role of Pharmacists in the Interprofessional Care Team for Patients with Chronic Diseases

Pharmacist interventions in an outpatient pain clinic at a Veterans Affairs Medical Center

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