The inpatient and outpatient pharmacy teams at JHH collaborated to improve their understanding of patients' medication use prior to admission through targeted medication reconciliation, education of patients on high-risk medications initiated during admission, and development of affordable and practical medication regimens that patients would receive in hand on discharge. A pharmacy team model was developed to ensure that these services are adequately provided and enhance patient understanding of the importance of medications for acute and chronic disease state management.
The implementation of a post-discharge, pharmacist-provided home-based medication management service enhanced the continuity of patient care during the transition from hospital to home. Pharmacists identified and resolved medication discrepancies, educated patients about their medications, and provided primary care providers and community pharmacies with a complete and reconciled medication list.
Objective
To determine how passively providing informational handouts and/or drug disposal kits affects rates of leftover prescription opioid disposal.
Design
A multi-arm parallel-group randomized controlled trial with masked outcome assessment and computer-guided randomization.
Setting
Johns Hopkins Health System outpatient pharmacies.
Subjects
Individuals who filled ≥1 short-term prescription for an immediate-release opioid for themselves or a family member.
Methods
In June 2019, 499 individuals were randomized to receive an informational handout detailing U.S. Food and Drug Administration–recommended ways to properly dispose of leftover opioids (n = 188), the informational handout and a drug disposal kit with instructions on its use (n = 170), or no intervention (n = 141) at prescription pickup. Subjects were subsequently contacted by telephone, and outcomes were assessed by a standardized survey. The primary outcome was the use of a safe opioid disposal method.
Results
By 6 weeks after prescription pickup, 227 eligible individuals reported they had stopped taking prescription opioids to treat pain and had leftover medication. No difference in safe disposal was observed between the non-intervention group (10% [6/63]) and the group that received disposal kits (14% [10/73]) (risk ratio = 1.44; 95% confidence interval: 0.55 to 3.74) or the group that received a fact sheet (11% [10/91]) (risk ratio = 1.15; 95% confidence interval: 0.44 to 3.01).
Conclusions
These findings suggest that passive provision of a drug disposal kit at prescription pickup did not increase rates of leftover opioid disposal when compared with provision of a fact sheet alone or no intervention. Active interventions may deserve further investigation.
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