ABSTRACT
Opioid stewardship is one essential function of pain and palliative care pharmacists and a critical need in the United States. In recent years, this country has been plagued by two public health emergencies: an opioid crisis and the COVID-19 pandemic, which has exacerbated the opioid epidemic through its economic and psychosocial toll. To develop an opioid stewardship program, a systematic approach is needed. This will be detailed in part here by the Opioid Stewardship Taskforce of the Society of Pain and Palliative Care Pharmacists (SPPCP), focusing on the role of the pharmacist. Many pain and palliative care pharmacists have made significant contributions to the development and daily operation of such programs while also completing other competing clinical tasks, including direct patient care. To ensure dedicated time and attention to critical opioid stewardship efforts, SPPCP recommends and endorses opioid stewardship models employing a full time, opioid stewardship pharmacist in both the inpatient and outpatient setting. Early research suggests that opioid stewardship pharmacists are pivotal to improving opioid metrics and pain care outcomes. However, further research and development in this area of practice is needed and encouraged.
Subject(s)
Analgesics, Opioid , COVID-19 , Humans , United States , Analgesics, Opioid/adverse effects , Pharmacists , Palliative Care , Pain Management , Pandemics , Pain/drug therapyABSTRACT
Prescription opioids were identified as being responsible for 14,000 deaths in 2019, with 9.3 million people admitting to misuse in 2020. This quality improvement project implemented the Institute for Clinical Systems Improvement (ICSI) guideline on pain management in acute care to decrease opioid prescriptions >90 morphine milliequivalents for acute-on-chronic pain. The change to current practice included completion of comprehensive functional assessments and opioid risk screening tools to guide a goal-directed shared decision-making discussion with patients. There was a statistically significant decrease in morphine milliequivalents per prescription (t43 = 2.579, P = .013).