Implementation of a pain medication stewardship program

Heroin use onset among nonmedical prescription opioid users in the club scene

“…To a large extent, this shift has occurred in an environment of increased efforts to reduce the adverse consequences of prescription opioids (Compton et al, 2016), including improved prescriber education (Alford et al, 2015; ONDCP, 2014), strengthening of prescription drug monitoring programs (Brady et al, 2014; Davis et al, 2014; Surratt et al, 2014), targeted law enforcement activities (Florida Department of Law Enforcement, 2012; Hall, 2015; Surratt et al, 2014), abuse-deterrent opioid formulations (Cicero et al, 2012a), the development and implementation of opioid prescribing guidelines (Frieden and Houry, 2016), and stewardship programs in healthcare settings to reduce the supply of opioids (Ghafoor et al, 2013). Although there is evidence to suggest that these types of initiatives have contributed to reductions in NMPOU and diversion of prescription opioids (Delcher et al, 2015; Rutlow et al, 2015; Surratt et al, 2014) their role in rising heroin use is unclear.…”

Children's cancer pain in a world of the opioid epidemic: Challenges and opportunities

“…Pharmacists can play a vital role in optimizing pain management and improving medication safety through customizing analgesic medications to the needs of the patient and clinical context and providing necessary patient education . The development and implementation of such stewardship programs generally involve creating a multidisciplinary team to identify barriers to optimal pain management, determine which patients may be at most risk for suboptimal pain management, and enact evidence‐based pain management practices that are disseminated through electronic medical record order sets and clinical services . Such programs have been shown to improve opioid safety by reducing reliance on opioids for both acute and chronic pain, and efforts by hospitals to adopt opioid stewardship programs may lead to improved care and safety of pain management in patients with cancer.…”

“…45 The development and implementation of such stewardship programs generally involve creating a multidisciplinary team to identify barriers to optimal pain management, determine which patients may be at most risk for suboptimal pain management, and enact evidence-based pain management practices that are disseminated through electronic medical record order sets and clinical services. 43,46 Such programs have been shown to improve opioid safety by reducing reliance on opioids for both acute and chronic pain, 47 and efforts by hospitals to adopt opioid stewardship programs may lead to improved care and safety of pain manage-ment in patients with cancer. Opioid stewardship programs may also be viewed as a component of multidisciplinary care for patients in pain.…”

Addressing the prescription opioid crisis: Potential for hospital‐based interventions?

“…In Kaweah Delta Medical centre in Visalia, California, a pharmacy pain management service program that combined opioid stewardship and physician requested consultations resulted in an overall decrease in opioid prescribing and initial savings of roughly $1.6 million USD related to opioid adverse drug events in which $400,000 USD was directly attributed to the program [22]. A hospital-based pain medication stewardship program in Minneapolis, Minnesota, demonstrated a number of successful interventions and consultations related to pain medication reconciliation [23]. Unfortunately, to our knowledge, none of the few existing opioid stewardship programs have undergone rigorous scientific evaluations and therefore, while the findings appear optimistic, there are certain limitations that cannot be ignored.…”