Transformation of Hospital Pharmacist Opioid Stewardship

Abstract

Purpose: The heightened involvement of government organizations to improve pain management and mitigate opioid adverse events brings to light the need for an opioid stewardship model. Summary: The US opioid epidemic has resulted in new hospital requirements for pain management by regulatory agencies. Opioid stewardship is a concept in the early development stage of pharmacy practice. There exists a need for a cohesive vision of opioid stewardship and the role of the pharmacist. Over the course of 17 years, the tracks for opioid stewardship in Fairview Health Services were laid through numerous initiatives to mitigate adverse events and improve the quality of pain management. This article will describe a transformation process for establishing the framework for opioid stewardship within Fairview Health Services and role of the pharmacist. Conclusions: The vision for opioid stewardship will ultimately be defined through the actions taken to improve quality care and patient safety. Opioid safety should be expanded to include stewardship of approaches that reduce the risk of diversion, overdose, and medication abuse. Pharmacists currently have a major role monitoring opioid medication in hospitals and this component will increase with new regulatory requirements.

Perioperative Pain Management and Opioid Stewardship: A Practical Guide

“…Some institutions have implemented opioid stewardship programs (OSPs) to achieve these goals. Core pillars of OSPs include interprofessional collaboration on protocols and services related to multimodal pain management, education on opioid prescribing and stewardship to staff and providers, education to patients, caregivers and community members on safe opioid use and disposal, opioid-related risk reduction, and data analysis and reporting of related quality metrics [ 38 , 66 , 68 , 519 , 520 , 521 , 522 ]. An expert panel has proposed quality indicators for measuring opioid stewardship interventions in hospital and emergency settings.…”

Optimizing Opioid Abuse Prevention Strategies: Role of Pharmacist in Safe Dispensing

“…"Doctor shopping" is a term used to describe the process of looking for a doctor obtaining prescriptions for controlled substances from multiple prescribers and pharmacies.9 Future studies are needed to compare the efficacy of various policies and practices aimed at increasing the range and effectiveness of prescription drug monitoring programmes [14].…”

“…The Project toward No Drug Abuse is a focused intervention and interactive system for high school students (ages [14][15][16][17][18][19] who choose to stay away from drugs and alcohol. Over the course of four weeks, this school-based curriculum includes twelve 40-to 50-minute lessons that include motivational activities, social skills instruction, and decision-making elements provided through group discussions, games, role-playing exercises, animations, and student worksheets [22].…”

Opioid Stewardship: Moving Beyond the “Why” to the “How”

“…3 Hopefully, these investigators will assess the impact of this tool on opioid use limiting the magnitude of dosage ranges, limiting initiation of parenteral administration to specific scenarios, and enhancing vigilance in administration of long-acting opioid formulations (patches or sustained-release oral dosage formulations) are examples of processes that pharmacists could undertake to reduce the risk associated with any obligatory opioid use. 6 Alternatively, a pharmacist's review of the quantity of opioid provided upon discharge may identify opportunities to reduce opioid exposure, although this approach has not been successful in all settings. 7 A group of pharmacists in Minneapolis, Minnesota, have published a thorough description of the expectations for review of all opioid treatments by pharmacists within their institutions, 6 which can serve as a good starting point for Canadian pharmacists wishing to establish realistic expectations of engagement.…”

“…6 Alternatively, a pharmacist's review of the quantity of opioid provided upon discharge may identify opportunities to reduce opioid exposure, although this approach has not been successful in all settings. 7 A group of pharmacists in Minneapolis, Minnesota, have published a thorough description of the expectations for review of all opioid treatments by pharmacists within their institutions, 6 which can serve as a good starting point for Canadian pharmacists wishing to establish realistic expectations of engagement.…”