Hospital pharmacists can help reduce opioid prescriptions
http://pharmacytoday.org/article/S1042-0991(16)30505-9/fulltext
A substantial amount of attention is being paid to our nation’s problem with opioid abuse, misuse, diversion, and addiction. Pharmacists are in an ideal position to help address the opioid epidemic and make sure these agents are used appropriately. Community pharmacists may play a role in reducing the number of opioid prescriptions filled, and I propose that hospital pharmacists can help reduce the number of opioid prescriptions written.
Medication reconciliation
The two primary times that hospital pharmacists can be involved are during admission and before discharge. During admission, hospital pharmacists often meet with the patient to perform a medication review to find out what medications a patient is taking at home. After the medication review and medication reconciliation, a hospital pharmacist may reach out to the patient’s community pharmacist to confirm the medication list. They may also check their state’s prescription drug monitoring program (PDMP) database to determine a patient’s home supply of opioids.
For example, if a hospital pharmacist notices that a patient had a prescription filled for oxycodone the day before being admitted for an elective total knee arthroscopy, then that pharmacist knows the surgeon will not have to write a prescription for this medication when discharging the patient. At this point, a hospital pharmacist could notify the surgeon of the patient’s home supply.
Medication reconciliation is often performed by hospital pharmacists before discharge. If a pharmacist notices that a patient will get a prescription for an opioid, then the pharmacist could check the PDMP to ensure that the patient does not already have an adequate supply at home. If the PDMP reveals that the patient already has a sufficient supply at home, then the pharmacist could counsel the patient to use his or her current home supply of opioids during discharge counseling. Another way a hospital pharmacist could reduce opioid prescriptions is to talk to the patient about ways to taper off pain medications.
HIGHLIGHTS
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Medication reconciliation during admission and discharge may help reduce opioid prescriptions.
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Hospital pharmacists may also educate patients and providers about prescribing.
Educate patients and prescribers
Beyond providing medication reconciliation and checking the PDMP, pharmacists, the medication experts on the team, have a role in educating patients, physicians, and other health care providers about appropriate prescribing practices. Recently, CDC released recommendations for prescribing opioid pain medications. The recommendations focus on use of opioids in treating chronic pain outside of active cancer treatment, palliative care, and end-of-life care. For more information about the recommendations, visit www.cdc.gov and see May’s Pharmacy Today.
Hospital pharmacists are busy professionals, but as the medication experts, they are perfectly positioned to counsel and educate patients and prescribers about the appropriate use of opioids to help reduce opioid prescriptions.
Joey Sweeney, PharmD, BCPS, Senior Clinical Pharmacist, Aurora Lakeland Medical Center, Elkhorn,
Filed under: General Problems
In my entire career, I’ve never seen a Pharmacist go near a patient, their room or their family while that patient was in the hospital. Not to educate them, counsel them or even to look at them. This is rediculous! It looks like this comes from a Pharmacy Publication. Looks to me like this manufactured “Opioid Crisis” gave someone an opportunity to publish in their field. Guess what? Patients and their families KNOW that they never see a hospital Pharmacist while being admitted, while staying, or upon discharge. Patients may be sick but they aren’t stupid.
This is what my pain management doctor saids,,I am not allowed to take my medicine for thoracic neuropathy for anything other then what he is prescribing it for,ie,thoracic neuropathy…My recent surgeries on my pancreatics duct,bile duct,gallbladder removal,,,,he called the surgeoen,,BEFORE,, the surgery,,,and told him my meds,,but also told him,,he,the surgeon, had to prescribe medicine for pain afterwards,,because if I took my pain medicine for my thoracic neuropathy,for recovery after this new surgery,,,I would run out tooo early,,thus it would appear i was filling my script early,,not good,,Soo the 2 came up w/a amount after surgery,,combined w/my normal pain meds to send me home w/after those above mentioned surgeries…My Doctor always,always tells me,,i am not allowed to take my pain meds for nothing,other then what he prescribes them for!!,,Anything else,broken leg,arm etc,,,its the other physicians responsibility to prescribe separate medicine for that injury,,,I always,call my pain doc,whenever I see any other doctor,,,ALWAYS!!!mary
By all means make sure that no one other than drug abusers get opiates. Since those people who properly and legally take opiates they are the ones who will suffer, The people who use them illegally will find a way to get and misuse them!! Makes me so angry I could chew nails and spit tacks!
This is above and beyond any reasonable action that should be expected of the hospital pharmacist! I cannot believe the extent to which opiophobia is running rampant in this country. Why don’t we try keeping patients out of pain and stop treating pain treatment as if it’s a crime waiting to happen?
This is truly infuriating, to say the least!
I don’t understand the assumption that just because someone is on regular opioids they won’t need more for the first few days after surgery. I had neurosurgery and my surgeon wrote some painkiller for me even though he knew I was already on them. I went home and tried to get through it without the extras and I couldn’t. I called my specialist, he approved the medication (since I have a contract with him), I got it and it helped me get through that bad first week.
Bull….no hospital pharmacist met with my husband on admission. The floor nurse called me about his meds he’s on so many. I called the hospital pharmacy myself to check what if any of his psyvh meds.were on formulary or not in case I had to being them in. I ended up.doing a.consultation with the hospital pharmacist because a couple meds they didnt carry and I couldnt bring in. So he was foing to pass my rexommendations to the hospitalist. Maybe I should get a discount on the bill