Opioid Misuse and Overdose: Changes in Pharmacist Practices and Outcomes

Abstract

Background: Continuing education (CE) provides educational opportunities for health professionals to adequately respond to issues in practice but infrequently evaluate sustained practice change. The opioid epidemic has risen to the forefront of health priorities in our nation. The Opioid and Naloxone Education (ONE Rx) CE program provides pharmacists the opportunity to expand their abilities and impact in the opioid crisis. Methods: ONE Rx CE included risk assessment for opioid misuse/overdose, role of naloxone, disease of addiction, and communication strategies for patients and providers. Pharmacists who completed the CE screened patients and provided interventions over 12 months. CE participants were provided presurveys, postsurveys, and delayed postsurveys coordinated with the educational program. The Kirkpatrick Model was used to evaluate the effectiveness of the program by examining the four levels of assessment: reaction, commitment, behavior, and results. Results: The Kirkpatrick Model was used to evaluate the impact of the CE. Reaction: 97% of respondents recommended the ONE Rx program. Commitment: 77% of respondents indicated commitment to provide ONE Rx opioid risk screening and interventions to patients. Behavior: Twelve months after training, pharmacists registered to prescribe naloxone increased by 67% and the number of pharmacists reporting naloxone dispensing doubled from 23% to 46%. Outcomes: Pharmacist interventions included medication take back programs explained (88.4%), naloxone dispensing to high-risk patients (10.9%), and discussion of opioid use disorder with patients with risk factors (49%). Conclusion: By using the Kirkpatrick Model, the ONE Rx CE program demonstrated high-quality opioid and naloxone education to pharmacists. Survey results and opioid harm reduction interventions indicate the CE resulted in sustained pharmacy practice behavior change.

Opioid risk screening: Program evaluation from the community pharmacists’ perspective

“…The details and outcomes of this education program have been previously published. 20,21 The program included 3 hours of continuing pharmacy education focusing on opioid risk education and use of an opioid risk screening tool. 22 Pharmacists were directed to use the screening tool with every patient filling a new opioid prescription and every 6 months for patients using opioids for chronic pain management.…”

Longitudinal Evaluation of Pharmacists’ Social Distance Preference and Attitudes toward Patients with Opioid Misuse following An Educational Training Program

“…Objectives, educational topics, methods, and practice-based outcomes of the ONE Program training have been previously published. 29,34 Nine training modules (online supplement 21,23,[32][33][34][35][36][37], were completed all at once if in-person, or at a self-directed pace if online.…”

“…Only the 6 questions pertaining to attitudes are reported here; those pertaining to experiences and practice behaviors are reported elsewhere. 34 A 5-point Likert scale was utilized; 1 ¼ strongly agree to 5 ¼ strongly disagree. This portion of the survey was based on a previously developed and validated survey.…”

Nurse delivered medication safety screening program for home care visits

“…Based on the success of this program and opportunities to share the outcomes of the work, the ONE Program was approached by various home health entities to translate the pillars of success to create a similar initiative to best serve patients who require healthcare delivery from their home. These included but are not limited to: positive patient perceptions of opioid risk screening, changes in pharmacist stigma related to opioid use disorder, and outcomes associated with initiation of an opioid risk screening program (Eukel et al., 2020; Skoy et al., 2020; Werremeyer, Frenzel, et al., 2022; Werremeyer, Strand, et al., 2022). Pharmacy and public health faculty at North Dakota State University designed a medication safety initiative, linked with opioid misuse and overdose prevention screening, to further enhance the health of patients receiving care in their homes across the state of North Dakota.…”