Nielsen Suzanne, Picco Louisa, Kowalski Michala, Sanfilippo Paul, Wood Pene, Larney Sarah, Bruno Raimondo, Ritter Alison
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.
Monash Addiction Research Centre, Monash University Peninsula Campus 47-49 Moorooduc Hwy, Frankston, 3199, Victoria, Australia.
Res Social Adm Pharm. 2020 Dec;16(12):1694-1701. doi: 10.1016/j.sapharm.2020.02.009. Epub 2020 Mar 2.
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.
This pilot aimed to test the implementation of software-facilitated Routine Opioid Outcome Monitoring (ROOM).
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.
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.
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.
鉴于处方阿片类药物造成的危害不断增加，近期的关注重点在于如何更好地利用社区药剂师来监测阿片类药物的使用效果。
本试点旨在测试软件辅助的常规阿片类药物结果监测（ROOM）的实施情况。
招募了澳大利亚维多利亚州和新南威尔士州的社区药房参与一项开放标签单臂观察性实施效果试点研究。药剂师完成了基线和随访访谈，以衡量在接受ROOM培训及实施后的知识和信心变化。配对t检验比较前后得分。邀请参与的患者完成一份简短的评估调查。收集了可行性和可接受性的衡量指标。
招募了来自23家药房的64名药剂师并对其进行了ROOM实施培训。20家药房（87%）能够实施ROOM，其中4家药房完成了20次筛查的目标。药剂师总共为152名患者完成了ROOM。44名药剂师提供了基线和随访数据，结果显示在识别和应对未处理的疼痛、抑郁及阿片类药物依赖方面的信心有显著提高。尽管有所提高，但随访时报告这些领域的信心仍处于低到中等水平。药剂师和患者的反馈表明ROOM的实施是可行且可接受的。
从基线到随访，药剂师在识别和应对阿片类药物相关问题的几个领域的信心显著提高，然而得分表明在应对阿片类药物相关问题方面仍有很大的信心提升空间。ROOM是可行且可接受的，不过更广泛的药剂师培训以及实践技能的机会可能有助于在这个具有挑战性的临床领域培养信心和技能。
