Implementation and assessment of a pilot, community pharmacy-based, opioid pain medication management program.

Publication date: Jan 08, 2020

This study aimed to evaluate care gaps in risk- and harm-reduction strategies for patients prescribed opioids and to describe the implementation of a community pharmacy-based, pilot pain-management program.

The pilot program was established in a community pharmacy within an academic medical center. Patients enrolled were prescribed opioids for chronic pain by a rheumatology clinic.

The patients enrolled met 1 or more of the following criteria: they were prescribed more than 1 short-acting opioid; more than 90 morphine milligram equivalents/d; and more than 7 days’ supply of medications for acute pain, including high-risk medication combinations. Comprehensive pain-medication assessments and pharmacist interventions were communicated to providers and implemented at follow-up. Data were analyzed using descriptive statistics.

A gap analysis was conducted by including 23 patients seen at the clinic over a 22-month period. The care gaps identified served as the basis for the pilot-program design.

Patients referred to the program were seen over a span of 1 to 2 visits; a total of 19 visits were documented. Pharmacists identified unaddressed issues with mood (68%). Recommendations made to the providers included additional adjuvant therapy (84%), dose adjustment (58%), and laboratory tests (74%). Naloxone was provided (58%), and education on naloxone use was provided at every visit.

Untreated depression, anxiety, and insomnia were the most common problems identified by pharmacists. Pharmacists implemented and documented risk-reduction strategies and coprescribed naloxone more frequently compared with clinic providers. The program enhanced the pharmacists’ ability to make safe and clinically appropriate decisions with regard to filling opioid prescriptions.

The pilot program identified care gaps and provided an approach for engaging with patients and providers to optimize pain management, implement opioid risk-reduction strategies, and expand naloxone access.

, Manzur, Mirzaian, E., Huynh, T., Lien, A., Ly, K., Wong, H., Wang, M., Lou, M., and Durham, M. Implementation and assessment of a pilot, community pharmacy-based, opioid pain medication management program. 04501. 2020 J Am Pharm Assoc (2003).

Concepts Keywords
Adjuvant Therapy Pain
Anxiety Pain management
Chronic Pain Adjuvant therapy
Community Pharmacy Drugs
Depression Psychoactive drugs
Descriptive Statistics Opioids
Harm Reduction RTT
Insomnia Morphinans
Milligram Morphine
Morphine Acute pain
Naloxone Ketones
Opioid Naloxone
Opioids Pain management
Pain Harm reduction
Pain Management Pharmacist
Pain Medication
Pharmacist
Rheumatology

Semantics

Type Source Name
disease MESH community
disease MESH chronic pain
drug DRUGBANK Methionine
drug DRUGBANK Morphine
drug DRUGBANK Naloxone
disease MESH depression
disease MESH anxiety
disease MESH insomnia

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