Evaluation of a Program to Screen Patients in Community Pharmacies for Opioid Misuse and Accidental Overdose

Abstract

What is already known on this topic?Pharmacists have a crucial role in the prevention of opioid misuse and accidental overdose. As initiatives to reduce opioid risks are undertaken, patient receipt of opioid interventions at pharmacies is necessary.

A scoping literature review of pharmacy-based opioid misuse screening and brief interventions

“…Five of the six intervention studies 21 , 22 , 23 , 24 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 (all except Ref ID 3) were rated high on all three factors: validity, reliability, and applicability. These studies had clear descriptions of appropriate methods and outcomes and used standardized instruments (validity), had sufficient sample sizes, and reported significant statistics (reliability), and had a clearly described SBI that could be used for future research (applicability).…”

“…Of the 24 records included in the qualitative synthesis, only six were intervention-based studies (Ref ID 1–6). 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 Two of these studies by Cochran et al involve the same intervention initially evaluated in a small-scale randomized control trial (RCT) (Ref ID 1) 21,22 with a larger active-control RCT (Ref ID 2) currently underway. 24 They used the Prescription Opioid Misuse Index as a screener and conducted motivational interviewing, counseling, medication therapy management, and naloxone navigation as brief interventions, with referral to treatment.…”

“…The other four intervention studies (Ref ID 3–6) used a cohort study design and reported positive outcomes related to pharmacist SBI practices. 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 One of these interventions (Ref ID 3) used naloxone as the brief intervention but did not specify their screening method. 25 Two intervention studies from the same research group (Ref ID 4&5) used patient counseling, partial fill, referral, and naloxone if indicated as their brief interventions and the Opioid Risk Tool as their main screening method.…”

“… 25 Two intervention studies from the same research group (Ref ID 4&5) used patient counseling, partial fill, referral, and naloxone if indicated as their brief interventions and the Opioid Risk Tool as their main screening method. 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 Their SBI showed good efficacy, patient satisfaction, and adoption and maintenance rates but needed improvement in the areas of reach and implementation. 28 , 29 , 30 , 31 , 32 , 33 Lastly, one intervention study from Australia (Ref ID 6) was a small-scale single-arm hybrid effectiveness and implementation study.…”

“… 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 Their SBI showed good efficacy, patient satisfaction, and adoption and maintenance rates but needed improvement in the areas of reach and implementation. 28 , 29 , 30 , 31 , 32 , 33 Lastly, one intervention study from Australia (Ref ID 6) was a small-scale single-arm hybrid effectiveness and implementation study. 34 , 35 , 36 Their SBI screened for both opioid misuse and overdose risk through the Routine Opioid Outcome Monitoring Tool and included education, counseling, naloxone, and contacting prescribers as their brief interventions.…”