J Am Pharm Assoc (2003). 2018 Jul-Aug;58(4):395-403. doi: 10.1016/j.japh.2018.03.005.
Community pharmacy continues to play a crucial role in the national response to the opioid epidemic. The purpose of this article is to describe the protocol for a pilot study that is examining the feasibility and acceptability of the Motivational Intervention-Medication Therapy Management (MI-MTM) model. This study also examines the preliminary clinical effect of MI-MTM for improving opioid medication misuse and patient activation in self-management of health conditions that increase risk for misuse.
MI-MTM is a pharmacy-based integrated care model made up of 4 evidence-based practices: medication therapy management; brief motivational intervention; patient navigation; and naloxone training and referral. To test MI-MTM compared with Standard Medication Counseling (SMC), we are conducting a 2-group randomized single-blinded controlled trial with assessments at 3 time points.
The study is being conducted within a western Pennsylvania university-based community pharmacy with 46 patients with opioid misuse (MI-MTM = 23; SMC = 23).
Feasibility will be measured by capturing patient completion rate of MI-MTM sessions. Acceptability will be measured by administering satisfaction surveys regarding pharmacist and patient navigator services. Acceptability will also be captured by conducting intensive qualitative interviews. Preliminary effect of the intervention on misuse will be measured with the use of the Prescription Opioid Misuse Index and the Opioid Compliance Checklist. Activation in self-management will be measured with the use of the Patient Activation Measure.
This project is currently recruiting, and results are to come.
This study is the first in the United States to implement an evidence-based integrated behavioral intervention into the community pharmacy setting to address opioid medication misuse among pharmacy patients. The results of this study will provide necessary foundational data that allow further testing of this intervention model in a larger trial.
社区药房在应对阿片类药物流行的国家应对措施中继续发挥关键作用。本文的目的是描述一项试点研究的方案，该研究旨在检查动机干预-药物治疗管理（MI-MTM）模式的可行性和可接受性。这项研究还检查了 MI-MTM 改善阿片类药物滥用和患者在自我管理增加滥用风险的健康状况方面的积极性的初步临床效果。
MI-MTM 是一种基于药房的综合护理模式，由 4 项基于证据的实践组成：药物治疗管理；简短的动机干预；患者导航；纳洛酮培训和转介。为了测试 MI-MTM 与标准药物咨询（SMC）相比，我们正在进行一项 2 组随机单盲对照试验，在 3 个时间点进行评估。
该研究在宾夕法尼亚州西部一所大学的社区药房进行，共有 46 名阿片类药物滥用患者（MI-MTM = 23；SMC = 23）。
通过捕捉患者完成 MI-MTM 疗程的比例来衡量可行性。通过对药剂师和患者导航服务的满意度调查来衡量可接受性。通过进行深入的定性访谈来捕获可接受性。干预对滥用的初步效果将通过使用处方阿片类药物滥用指数和阿片类药物依从性检查表来衡量。自我管理中的积极性将通过使用患者积极性衡量来衡量。
该项目正在招募参与者，结果即将公布。
这项研究是美国首次在社区药房环境中实施基于证据的综合行为干预措施，以解决药房患者的阿片类药物滥用问题。这项研究的结果将提供必要的基础数据，以便在更大规模的试验中进一步测试该干预模型。
