Systematic monitoring of opioid-related outcomes in community pharmacies presents opportunities
With a simple intervention, pharmacists became compassionate and caring while their efficiency in treating patients improved.
There is nothing wrong with being opportunistic. In fact, being opportunistic is generally good for your patients and your practice. Being an opportunist in pharmacy means helping to meet unmet needs and solve problems. We often think of value-added services such as those dealing with chronic diseases or with regard to public health initiatives, such as vaccination. Much has been said and done to address the problem of opioid abuse. This has included pharmacy, but there are still many patients who can be helped now and in the future, and the opportunity to do so presents itself almost daily.
In a study published in Research in Social and Administrative Pharmacy, researchers piloted the implementation of a routine opioid outcome monitoring program (ROOM) facilitated by software. The study authors remind readers of the persistent problem of opioid abuse and its comorbidities such as depression, its concurrent problems such as alcohol and benzodiazepine abuse, and common adverse effects and quality of life issues such as constipation. Although extensive clinical assessment tools exist for opioid prescribers, methods to facilitate rapid and consistent use of opioid use monitoring are far less available.
The study authors used the theory of planned behavior to guide the design of clinical intervention that would increase pharmacists’ ability, motivation, and opportunity to identify and respond to opioid-related problems, and called ROOM given its ability to adapt to everyday life. practice. He used the use of software that prompted pharmacists to offer the ROOM tool to patients receiving a second or subsequent opioid prescription.
The ROOM tool consists of a few questions and screens to stratify patient risk. Pharmacists have been trained in its use and familiarization with the software. There were 64 pharmacists from 23 pharmacies who completed ROOM with 152 patients. Post-implementation, pharmacists reported being more confident in identifying patient risks and responding to patients who may develop addiction and depression, having more knowledge about naloxone, and being more comfortable with intervene when they are concerned about an opioid prescription. Patients who completed the ROOM tool at the pharmacy received an evaluation survey by email and indicated that it was easy to complete and provided useful information.
While there are many tools to aid in monitoring, care provided prospectively by pharmacists can add great value, elevate practice, and improve outcomes. The idea behind this intervention was not just to curb abuse, but also to help patients undergoing opioid treatment and to lessen adverse effects and shape behaviors that can lessen associated concomitant deleterious events. to the use of opioids. Rather than being the “opioid police,” pharmacists have proven to be compassionate and caring, while their efficiency in treating patients has improved.
This is an example of simple interventions that are an integral part of practice. Pharmacy managers can instill this kind of culture in the pharmacy, and pharmacy staff can show empathy and knowledge that will make patients more satisfied and, as a result, have a better life.
Additional information on value-added services as a component of improving the roles of pharmacists in public health and managing the technology that supports the medication use process can be found in Pharmacy Management: Essentials for All Practice Settings, 5th.
Nielsen S, Picco L, Kowalski M, Sanfilippo P, et al. Routine monitoring of opioids in the community pharmacy: results of an open-label pilot study of the effectiveness of single-arm implementation. Res Social Admin Pharm. 2020;16(12):1694-1701.
ABOUT THE AUTHOR
Shane P. Desselle, RPh, PhD, FAPhAis Professor of Social and Behavioral Pharmacy at Touro University California College of Pharmacy.