A pharmacist-led intervention to improve the management of opioids in a general practice: a qualitative evaluation of participant interviews

Jordan, Margaret; Young-Whitford, Meredith; Mullan, Judy; Stewart, Adele; Chen, Timothy

doi:10.1007/s11096-021-01340-0

Cited by 3 publications

(2 citation statements)

References 72 publications

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“…Overprescribing of opioids in the postoperative setting is a common problem, contributing to the high consumption of opioids in multiple countries worldwide and leading to possible misuse [4]. Prescribers and pharmacists worldwide are trained and provided with a range of guidelines to improve opioid management [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Prolonged oxycodone use and potential risk factors in postoperative patients: a case control study

et al. 2022

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Background Prolonged exposure to opioids has a negative influence on the physical and mental health of a person. Currently, little is known about the risk of prolonging opioids after first postoperative use. Aim A study was conducted to define the proportion of postoperative patients that use oxycodone longer than prescribed to determine risk factors of prolonged use. Method This retrospective single-center nested case-control study was performed in the Elisabeth Tweesteden Hospital. The study population consisted of postoperative adult patients who received an oxycodone prescription at discharge between April 2018 and June 2020. The primary outcome was the proportion of patients with at least one refill of oxycodone during a followup period of 30 days. The secondary outcome was the association of potential risk factors with oxycodone refills. Univariate and multivariate logistic regression analyses were performed to determine the association between the variables and outcome. Results 1203 patients were included of which 280 (23.3%) received one or more refill. Age (adjusted odds ratio 1.01 [95% confidence interval 1.00-1.02]), length of stay (1.10 [1.06-1.14], a Numeric Rating Scale pain score of four or higher (1.52 [1.14-2.01]), use of the continuous release form only (2.15 [1.60-2.89]) and admission to various hospital departments were associated with a refill of oxycodone . ConclusionThe proportion of patients with a refill of oxycodone is 23.3%. This could result in chronic oxycodone use and potential misuse. Patients with the determined risk factors may be a suitable population for future interventions to minimize prolonged use.

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Section: Introductionmentioning

confidence: 99%

Prolonged oxycodone use and potential risk factors in postoperative patients: a case control study

et al. 2022

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“…The characteristics of each study and extracted barriers and facilitators can be seen in Table 3. Of the 56 articles retrieved, 28 used quantitative methods, [19, 21, 23, 24, 26, 28, 30, 32, 33, 35, 37, 39, 41, 42, 45, 47, 49, 51, 54-58, 60-62, 67, 70] 21 used qualitative methods, [20,22,25,27,29,34,36,38,40,43,46,52,53,59,63,64,68,[71][72][73][74] 3 articles employed mixed methods [31,48,50] and 4 articles used multimethods. [44,65,66,69] Most research articles originated from the Netherlands (n = 9), USA and Canada (n = 8) followed by Australia (n = 6), UK and Spain (n = 5), Germany and Denmark (n = 3), New Zealand and Italy (n = 2) and France, Switzerland, Norway, Malaysia and Slovenia (n = 1).…”

Section: Study Characteristicsmentioning

confidence: 99%

Barriers and facilitators of implementing proactive deprescribing within primary care: a systematic review

Okeowo

Zaidi

Fylan

et al. 2023

International Journal of Pharmacy Practice

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Objective Proactive deprescribing – identifying and discontinuing medicines where harms outweigh benefits – can minimise problematic polypharmacy, but has yet to be implemented into routine practice. Normalisation process theory (NPT) can provide a theory-informed understanding of the evidence base on what impedes or facilitates the normalisation of routine and safe deprescribing in primary care. This study systematically reviews the literature to identify barriers and facilitators to implementing routine safe deprescribing in primary care and their effect on normalisation potential using NPT. PubMed, MEDLINE, Embase, Web of Science, International Pharmaceutical Abstracts, CINAHL, PsycINFO and The Cochrane Library were searched (1996–2022). Studies of any design investigating the implementation of deprescribing in primary care were included. The Mixed Methods Appraisal Tool and the Quality Improvement Minimum Quality Criteria Set were used to appraise quality. Barriers and facilitators from included studies were extracted and mapped to the constructs of NPT. Key findings A total of 12,027 articles were identified, 56 articles included. In total, 178 barriers and 178 facilitators were extracted and condensed into 14 barriers and 16 facilitators. Common barriers were negative deprescribing perceptions and suboptimal deprescribing environments, while common facilitators were structured education and training on proactive deprescribing and utilising patient-centred approaches. Very few barriers and facilitators were associated with reflexive monitoring, highlighting a paucity of evidence on how deprescribing interventions are appraised. Summary Through NPT, multiple barriers and facilitators were identified that impede or facilitate the implementation and normalisation of deprescribing in primary care. However, more research is needed into the appraisal of deprescribing post-implementation.

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Stakeholders' perspectives and experiences of the pharmacist's role in deprescribing in ambulatory care: A qualitative meta-synthesis

Kassis,

Moles,

Carter

2024

Research in Social and Administrative Pharmacy

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A pharmacist-led intervention to improve the management of opioids in a general practice: a qualitative evaluation of participant interviews

Cited by 3 publications

References 72 publications

Prolonged oxycodone use and potential risk factors in postoperative patients: a case control study

Prolonged oxycodone use and potential risk factors in postoperative patients: a case control study

Barriers and facilitators of implementing proactive deprescribing within primary care: a systematic review

Stakeholders' perspectives and experiences of the pharmacist's role in deprescribing in ambulatory care: A qualitative meta-synthesis

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