Literature DB >> 32109955

Designing a Pharmacist Opioid Safety and Intervention Tool.

Brendan Woods1, Michael Legal2, Stephen Shalansky3, Tamara Mihic4, Winnie Ma5.   

Abstract

BACKGROUND: Despite the recent increase in opioid overdoses across Canada, few pharmacy-led initiatives have been implemented to address issues related to opioid prescribing in the hospital setting.
OBJECTIVES: The primary objective of this study was to develop a clinical tool, intended for use by hospital pharmacists and informed by best practices from the literature, that would provide a structured approach to enhancing the safety of opioid prescribing. The secondary objective was to collect pharmacists' opinions about the feasibility and utility of this tool.
METHODS: A comprehensive literature search and pharmacist focus group analysis provided content for development of a candidate clinical tool. This tool was then piloted by clinical pharmacists working on general medical and surgical units in a single hospital. Pharmacists participating in the pilot were invited to complete an online survey concerning their perceptions of the tool. Descriptive statistics were used to analyze the survey results.
RESULTS: The literature search and focus group analysis led to development of a candidate clinical tool that focused on Medication review, Optimization, Reassessment, and Education (MORE). It included key risk factors relating to opioid safety, along with suggested mitigating strategies. The MORE tool was piloted for 3 weeks by 14 clinical pharmacists, 9 of whom responded to the subsequent survey. Five respondents indicated that the clinical tool increased their ability to identify risk factors. Five respondents also noted an increase in their ability to identify possible interventions. Most respondents felt that the tool was useful and that it would be feasible to integrate it into their practice; however, they noted that a more streamlined version could improve ease of use.
CONCLUSIONS: The MORE tool was well received by clinical pharmacists. Implementation of the tool into routine practice requires additional changes to improve ease of use. Suggestions for modifying and streamlining the tool will be incorporated into future versions. 2020 Canadian Society of Hospital Pharmacists. All content in the Canadian Journal of Hospital Pharmacy is copyrighted by the Canadian Society of Hospital Pharmacy. In submitting their manuscripts, the authors transfer, assign, and otherwise convey all copyright ownership to CSHP.

Entities:  

Keywords:  clinical tool; opioids; pharmacist; stewardship

Year:  2020        PMID: 32109955      PMCID: PMC7023926     

Source DB:  PubMed          Journal:  Can J Hosp Pharm        ISSN: 0008-4123


  8 in total

Review 1.  Prescription opioid related misuse, harms, diversion and interventions in Canada: a review.

Authors:  Benedikt Fischer; Elena Argento
Journal:  Pain Physician       Date:  2012-07       Impact factor: 4.965

2.  Making psychological theory useful for implementing evidence based practice: a consensus approach.

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3.  Implementation of a pain medication stewardship program.

Authors:  Virginia L Ghafoor; Pamela Phelps; John Pastor
Journal:  Am J Health Syst Pharm       Date:  2013-12-01       Impact factor: 2.637

4.  Patterns in the use of benzodiazepines in British Columbia: examining the impact of increasing research and guideline cautions against long-term use.

Authors:  Colleen M Cunningham; Gillian E Hanley; Steve Morgan
Journal:  Health Policy       Date:  2010-04-21       Impact factor: 2.980

5.  "Every 'never' I ever said came true": transitions from opioid pills to heroin injecting.

Authors:  Sarah G Mars; Philippe Bourgois; George Karandinos; Fernando Montero; Daniel Ciccarone
Journal:  Int J Drug Policy       Date:  2013-10-19

6.  High levels of opioid analgesic co-prescription among methadone maintenance treatment clients in British Columbia, Canada: results from a population-level retrospective cohort study.

Authors:  Bohdan Nosyk; Benedikt Fischer; Huiying Sun; David C Marsh; Thomas Kerr; Juergen T Rehm; Aslam H Anis
Journal:  Am J Addict       Date:  2014 May-Jun

7.  Opioid Prescribing at Hospital Discharge Contributes to Chronic Opioid Use.

Authors:  Susan L Calcaterra; Traci E Yamashita; Sung-Joon Min; Angela Keniston; Joseph W Frank; Ingrid A Binswanger
Journal:  J Gen Intern Med       Date:  2016-05       Impact factor: 5.128

8.  Validation of the theoretical domains framework for use in behaviour change and implementation research.

Authors:  James Cane; Denise O'Connor; Susan Michie
Journal:  Implement Sci       Date:  2012-04-24       Impact factor: 7.327

  8 in total
  1 in total

1.  Evaluating a Pharmacist-Led Opioid Stewardship Initiative at an Urban Teaching Hospital.

Authors:  Anna Chen; Michael Legal; Stephen Shalansky; Tamara Mihic; Victoria Su
Journal:  Can J Hosp Pharm       Date:  2021-07-01
  1 in total

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