Routine opioid outcome monitoring in community pharmacy: Outcomes from an open-label single-arm implementation-effectiveness pilot study

Suzanne Nielsen; Louisa Picco; Michala Kowalski; Paul Sanfilippo; Pene Wood; Sarah Larney; Raimondo Bruno; Alison Ritter

doi:10.1016/j.sapharm.2020.02.009

Routine opioid outcome monitoring in community pharmacy: Outcomes from an open-label single-arm implementation-effectiveness pilot study

Res Social Adm Pharm. 2020 Dec;16(12):1694-1701. doi: 10.1016/j.sapharm.2020.02.009. Epub 2020 Mar 2.

Authors

Suzanne Nielsen¹, Louisa Picco², Michala Kowalski³, Paul Sanfilippo², Pene Wood⁴, Sarah Larney³, Raimondo Bruno⁵, Alison Ritter⁶

Affiliations

¹ Monash Addiction Research Centre, Monash University Peninsula Campus 47-49 Moorooduc Hwy, Frankston, 3199, Victoria, Australia; National Drug and Alcohol Research Centre, University of New South Wales Sydney, NSW, 2052, Australia. Electronic address: Suzanne.nielsen@monash.edu.
² Monash Addiction Research Centre, Monash University Peninsula Campus 47-49 Moorooduc Hwy, Frankston, 3199, Victoria, Australia.
³ National Drug and Alcohol Research Centre, University of New South Wales Sydney, NSW, 2052, Australia.
⁴ Department of Pharmacy and Biomedical Science, Latrobe University, PO box 199 Bendigo, Victoria, 3552, Australia.
⁵ National Drug and Alcohol Research Centre, University of New South Wales Sydney, NSW, 2052, Australia; School of Medicine, University of Tasmania, Churchill Ave, Sandy Bay, 7005, Hobart, Australia.
⁶ Drug Policy Modelling Program, Social Policy Research Centre, Kensington Campus, University of New South Wales, Sydney, Australia.

PMID: 32273255
DOI: 10.1016/j.sapharm.2020.02.009

Abstract

Background: In response to rising harms with prescription opioids, recent attention has focused on how to better utilise community pharmacists to monitor outcomes with opioid medicines.

Objective: This pilot aimed to test the implementation of software-facilitated Routine Opioid Outcome Monitoring (ROOM).

Methods: Community pharmacies in Victoria and New South Wales, Australia, were recruited to an open-label single-arm observational implementation-effectiveness pilot study. Pharmacists completed baseline and follow up interviews to measure change in knowledge and confidence following training on, and implementation of ROOM. Paired t-tests compared pre-post scores. Patients that participated were invited to complete a brief evaluation survey. Measures of feasibility and acceptability were collected.

Results: Sixty-four pharmacists from 23 pharmacies were recruited and trained to conduct ROOM. Twenty pharmacies (87%) were able to implement ROOM, with four pharmacies completing the target of 20 screens. Pharmacists completed ROOM with 152 patients in total. Forty-four pharmacists provided baseline and follow-up data which demonstrated significant improvements in confidence identifying and responding to unmanaged pain, depression and opioid dependence. Despite increases, low to moderate confidence for these domains was reported at follow-up. Responses from pharmacists and patients indicated that implementation of ROOM was feasible and acceptable.

Conclusions: Pharmacists' confidence in identifying and responding to opioid-related problems significantly increased from baseline to follow up across several domains, however scores indicated that there is still significant scope to further increase confidence in responding to opioid-related problems. ROOM is feasible and acceptable, though more extensive pharmacist training with opportunity to practice skills may assist in developing confidence and skills in this challenging clinical area.

Keywords: Community pharmacy; Implementation study; Naloxone; Opioids; Overdose; Pharmacy practice.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Analgesics, Opioid
Community Pharmacy Services*
Humans
Naloxone
New South Wales
Pharmacies*
Pharmacists
Pilot Projects
Victoria

Substances

Analgesics, Opioid
Naloxone