Opioid Safety: A Community Pharmacy Intervention to Prevent Opioid Adverse Drug Events
Combatting the opioid epidemic is a top national priority and identification of effective public health strategies is of primary importance.1 Since 1999, the amount of prescription opioids sold in the U.S. nearly quadrupled.2 Reducing adverse drug events (ADEs), particularly those attributed to opioids, is also a national priority.3
This Special Innovation Project, implemented in the AQIN area of New York State, the District of Columbia, and South Carolina, is tailored to enhance usual care pharmacist counseling with opioid-specific content, such as communicating explicitly that opioid use exposes the patient to dependence and addiction. Specific pharmacist-patient interventions will include assessment of patient risk for overdose and naloxone offer, if appropriate, and laxative and stool softener recommendations to prevent opioid induced constipation. Specific pharmacist-prescriber interventions will include contacting the prescriber for benzodiazepine de-escalation when used concurrently with opioids, if appropriate and informing prescribers when morphine milligram equivalent (MME) daily dose exceeds ≥ 90 MME.4 The intervention will be implemented within the pharmacist dispensing workflow for all patients presenting with opioid prescriptions in volunteer recruited pharmacies. The desired outcomes include an increase in the number of naloxone prescriptions dispensed by participating pharmacies and a decrease in the incidence of opioid-related emergency department visits for Medicare fee-for-service beneficiaries.
Continuing education training created by the University at Buffalo School of Pharmacy and Pharmaceutical Sciences, Office of Continuing Pharmacy Education and advanced pharmacist counseling materials are also provided for all participating pharmacists. Recruitment of pharmacies for this project is closed, however pharmacists can still obtain the training and receive ACPE© credits and use the counseling materials via the links below.
The continuing education activities are:
- "Pharmacist's Response to the Opioid Epidemic: Advanced, Opioid Specific Counseling", providing 1.5 ACPE© credits.
- "Naloxone Pharmacy Continuing Education Program", providing 2 ACPE© credits.
They can be accessed here.
THE COURSE CONTENT INCLUDES EXAMPLES AND REFERENCES to NEW YORK STATE LAWS, REGULATIONS AND RESOURCES. PLEASE REFER TO YOUR SPECIFIC STATE LAWS AND REGULATIONS WHEN AND WHERE APPLICABLE.
Pharmacists who work in New York State, the District of Columbia and South Carolina can waive the fee for the CE by using the appropriate code based on the state you work in: aqin2018NY, aqin2018DC, aqin2018SC.
Advanced Opioid Patient Counseling Materials
Opioid Stewardship: Opioid Counseling checklist – A tool intended to help remind pharmacists about opioid-related counseling points as needed when using the conversation starter. Click here to view the tool.
Conversation starter: Opioid dispensing, education, and management for pharmacists – A tool designed to aid the pharmacist in starting the conversation about opioids with patients and care givers. Click here to view the tool.
PEG Scale Assessing Pain Intensity and Interference (Pain, Enjoyment, General Activity) – A tool to assess a patient’s pain, enjoyment, and ability to accomplish their general activities. Click here to view the tool.
Pain Zone Tool – A tool to help the patient rate their comfort level and what to do depending on their responses. Click here to view the tool.
For more information contact:
New York State: Tanya Vadala, Pharm.D.
District of Columbia: Jennifer Thomas, Pharm.D.
South Carolina: Cheryl Anderson, BS, RPh.
- 1 Schuchat A, Houry D, Guy GP. New data on opioid use and prescribing in the US.JAMA,2017 Jul 6; doi:10.1001/jama.2017.8913
- 2 CDC. Wide-ranging online data for epidemiologic research (WONDER). Atlanta, GA: CDC, National Center for Health Statistics; 2016. Available at http://wonder.cdc.gov
- 3 U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. (2014). National Action Plan for Adverse Drug Event Prevention. Washington, DC
- 4 Dowell D, Haegerich TM, Chou R. CDC Guideline for Prescribing Opioids for Chronic Pain —United States, 2016. MMWR Recomm Rep 2016;65(No. RR-1):1–49. DOI: http://dx.doi.org/10.15585/mmwr.rr6501e1