Opioid misuse in community pharmacy patients with chronic non‐cancer pain

2021 ◽  
Author(s):  
Camille Philip ◽  
Sophie Roy ◽  
Céline Eiden ◽  
Marion Soler ◽  
François Georgin ◽  
...  
Keyword(s):  
Cancer Pain ◽  
Community Pharmacy ◽  
Opioid Misuse

scholarly journals Risk Stratification of Opioid Misuse among Patients with Cancer Pain Using the SOAPP-SF

Pain Medicine ◽  
2013 ◽  
Vol 14 (5) ◽  
pp. 667-675 ◽  
Author(s):  
Dhanalakshmi Koyyalagunta ◽  
Eduardo Bruera ◽  
Carrie Aigner ◽  
Harun Nusrat ◽  
Larry Driver ◽  
...  
Keyword(s):  
Risk Stratification ◽  
Cancer Pain ◽  
Opioid Misuse ◽  
Patients With Cancer

scholarly journals Standardizing Opioid Prescribing Practices for Cancer-Related Pain Via a Novel Interactive Documentation Template at a Public Hospital

2019 ◽  
Vol 15 (11) ◽  
pp. e989-e996 ◽  
Author(s):  
Maliha Nusrat ◽  
Amanda Parkes ◽  
Ryan Kieser ◽  
Bei Hu ◽  
Dalia Farhat ◽  
...  
Keyword(s):  
At Risk ◽  
Pain Management ◽  
Cancer Pain ◽  
Systematic Approach ◽  
Opioid Misuse ◽  
Prescribing Practices ◽  
Cancer Pain Management ◽  
Opioid Prescribing ◽  
Community Oncology ◽  
Ensure Patient Safety

PURPOSE: Opioid misuse during cancer pain management places patients at risk for harm and physicians for legal liability. Identifying and monitoring patients who are at risk is challenging given the lack of validated clinical tools and evidence-based guidelines. In the current study, we aimed to standardize opioid prescribing practices at a community oncology clinic to help ensure patient safety and physician compliance with Texas state regulations. METHODS: We used the Plan-Do-Study-Act methodology. In the planning phase, current practices of assessing opioid efficacy, toxicity, and misuse were determined by surveying clinic physicians and reviewing patients’ charts. We developed a new standardized process that incorporated published literature, the Texas Administrative Code, and expert opinion. Two interactive documentation templates (SmartPhrases) were designed to implement the standardized process. The intervention was studied using repeat physician surveys and chart reviews, which prompted action for refinement and sustainability. RESULTS: At baseline, 9% of providers followed a systematic approach to prescribing opioids and 86% expressed an interest in process standardization. We noted high interprovider variability in the opioid risk stratification and refill process. At 2 months and 6 months postimplementation, provider satisfaction with the intervention was 83% and 75%, whereas compliance with SmartPhrase use was 70% and 54%, respectively. The frequency of state database check improved from 36% to 94% at 6 months. Improvement was also noted in assessment and documentation of baseline risk, chemical coping, and toxicity. CONCLUSION: We implemented a systematic approach for assessing opioid misuse, toxicity, and efficacy during cancer pain management at a community oncology clinic. The approach resulted in notable improvement in provider practices and documentation compliance.

Oramorph - two liquid morphine formulations

1989 ◽  
Vol 27 (18) ◽  
pp. 71-72
Keyword(s):  
Aqueous Solution ◽  
Cancer Pain ◽  
Community Pharmacy ◽  
Initial Dose ◽  
Slow Release ◽  
Oral Morphine ◽  
Morphine Sulphate ◽  
Dose Titration

Oral morphine is the standard analgesic for severe opioid-responsive cancer pain.1 It is traditionally used as an aqueous solution, prepared as needed by the hospital or community pharmacy, and although slow-release morphine sulphate tablets (MST-Continus) are now widely used many doctors still prescribe an aqueous solution for initial dose titration, for top-up use, “as needed” use and for patients who dislike tablets.2

scholarly journals Factors associated with prescription opioid misuse in a cross-sectional cohort of patients with chronic non-cancer pain

2017 ◽  
Vol Volume 10 ◽  
pp. 979-987 ◽  
Author(s):  
Jennifer Hah ◽  
John Sturgeon ◽  
Jennifer Zocca ◽  
Yasamin Sharifzadeh ◽  
Sean Mackey
Keyword(s):  
Cancer Pain ◽  
Prescription Opioid ◽  
Opioid Misuse ◽  
Cross Sectional ◽  
Factors Associated ◽  
Prescription Opioid Misuse

Opioid Misuse and Abuse: Risk Assessment and Management in Patients with Cancer Pain

2013 ◽  
Vol 11 (8) ◽  
pp. 1023-1031 ◽  
Author(s):  
Doralina L. Anghelescu ◽  
Jennifer Harman Ehrentraut ◽  
Lane G. Faughnan
Keyword(s):  
Risk Assessment ◽  
Cancer Pain ◽  
Opioid Misuse ◽  
Patients With Cancer ◽  
Abuse Risk ◽  
Risk Assessment And Management

scholarly journals Prescription Opioid Misuse Among Rural Community Pharmacy Patients: Pilot Study for Screening and Implications for Future Practice and Research

2016 ◽  
Vol 30 (5) ◽  
pp. 498-505 ◽  
Author(s):  
Gerald T. Cochran ◽  
Rafael J. Engel ◽  
Valerie J. Hruschak ◽  
Ralph E. Tarter
Keyword(s):  
Rural Communities ◽  
Community Pharmacy ◽  
Rural Areas ◽  
Pilot Project ◽  
Prescription Opioid ◽  
Opioid Misuse ◽  
Rural And Urban ◽  
Increased Risk ◽  
Rural Settings ◽  
Prescription Opioid Misuse

Background: Opioid misuse imposes a disproportionately heavy burden on individuals living in rural areas. Community pharmacy has the potential to expand and coordinate with health professionals to identify and intervene with those who misuse opioids. Objective: Rural and urban community pharmacy patients were recruited in this pilot project to describe and compare patterns of opioid misuse. Methods: We administered a health screening survey in 4 community pharmacies among patients filling opioid medications. Univariate statistics were used to assess differences in health characteristics and opioid medication misuse behaviors between rural and urban respondents. Multivariable statistics were used to identify risk factors associated with rural and urban opioid misuse. Results: A total of 333 participants completed the survey. Participants in rural settings had poorer overall health, higher pain levels, lower education, and a higher rate of unemployment compared to patients in urban pharmacies. Rural respondents with illicit drug use (adjustable odds ratio [aOR]: 14.34, 95% confidence interval [CI] = 2.16-95.38), posttraumatic stress disorder (aOR: 5.44, 95% CI = 1.52-19.50), and ≤high school education (aOR: 6.68, 95% CI = 1.06-42.21) had increased risk for opioid misuse. Conclusions: Community pharmacy represents a promising resource for potential identification of opioid misuse, particularly in rural communities. Continued research must extend these findings and work to establish collaborative services in rural settings.

scholarly journals Risk of opioid misuse in chronic non-cancer pain in primary care patients - a cross sectional study

2018 ◽  
Vol 19 (1) ◽  
Author(s):  
Johannes Maximilian Just ◽  
Linda Bingener ◽  
Markus Bleckwenn ◽  
Rieke Schnakenberg ◽  
Klaus Weckbecker
Keyword(s):  
Primary Care ◽  
Cancer Pain ◽  
Cross Sectional Study ◽  
Opioid Misuse ◽  
Sectional Study ◽  
Cross Sectional ◽  
Primary Care Patients

scholarly journals Screening Community Pharmacy Patients for Risk of Prescription Opioid Misuse

2015 ◽  
Vol 9 (5) ◽  
pp. 411-416 ◽  
Author(s):  
Gerald Cochran ◽  
Jessica Rubinstein ◽  
Jennifer L. Bacci ◽  
Thomas Ylioja ◽  
Ralph Tarter
Keyword(s):  
Community Pharmacy ◽  
Prescription Opioid ◽  
Opioid Misuse ◽  
Prescription Opioid Misuse

scholarly journals Risk of opioid misuse in people with cancer and pain and related clinical considerations: a qualitative study of the perspectives of Australian general practitioners

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e034363
Author(s):  
Tim Luckett ◽  
Toby Newton-John ◽  
Jane Phillips ◽  
Simon Holliday ◽  
Karleen Giannitrapani ◽  
...  
Keyword(s):  
Cancer Pain ◽  
General Practitioners ◽  
Continuity Of Care ◽  
Chronic Phase ◽  
Opioid Therapy ◽  
Integrative Approach ◽  
Opioid Misuse ◽  
Opioid Prescribing ◽  
Clinical Considerations ◽  
Disease Free

ObjectiveTo explore the perspectives of general practitioners (GPs) concerning the risk of opioid misuse in people with cancer and pain and related clinical considerations.DesignA qualitative approach using semistructured telephone interviews. Analysis used an integrative approach.SettingPrimary care.ParticipantsAustralian GPs with experience of prescribing opioids for people with cancer and pain.ResultsTwenty-two GPs participated, and three themes emerged. Theme 1 (Misuse is not the main problem) contextualised misuse as a relatively minor concern compared with pain control and toxicity, and highlighted underlying systemic factors, including limitations in continuity of care and doctor expertise. Theme 2 (‘A different mindset’ for cancer pain) captured participants’ relative comfort in prescribing opioids for pain in cancer versus non-cancer contexts, and acknowledgement that compassion and greater perceived community acceptance were driving factors, in addition to scientific support for mechanisms and clinical efficacy. Participant attitudes towards prescribing for people with cancer versus non-cancer pain differed most when cancer was in the palliative phase, when they were unconcerned by misuse. Participants were equivocal about the risk–benefit ratio of long-term opioid therapy in the chronic phase of cancer, and were reluctant to prescribe for disease-free survivors. Theme 3 (‘The question is always, ‘how lazy have you been?’) captured participants’ acknowledgement that they sometimes prescribed opioids for cancer pain as a default, easier option compared with more holistic pain management.ConclusionsFindings highlight the role of specific clinical considerations in distinguishing risk of opioid misuse in the cancer versus non-cancer population, rather than diagnosis per se. Further efforts are needed to ensure continuity of care where opioid prescribing is shared. Greater evidence is needed to guide opioid prescribing in disease-free survivors and the chronic phase of cancer, especially in the context of new treatments for metastatic disease.

scholarly journals How do patients with cancer pain view community pharmacy services? An interview study

2018 ◽  
Vol 26 (4) ◽  
pp. 507-518 ◽  
Author(s):  
Zoe Edwards ◽  
Alison Blenkinsopp ◽  
Lucy Ziegler ◽  
Michael I. Bennett
Keyword(s):  
Cancer Pain ◽  
Community Pharmacy ◽  
Interview Study ◽  
Community Pharmacy Services ◽  
Pharmacy Services ◽  
Patients With Cancer
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