North Dakota State University School of Pharmacy, PO Box 6050, Dept 2660, Fargo, ND 58108. Email:
North Dakota State University School of Pharmacy, Fargo, North Dakota.
Prev Chronic Dis. 2022 Jul 14;19:E41. doi: 10.5888/pcd19.220028.
Community pharmacies nationwide have adopted new strategies to combat the opioid epidemic. One strategy to prevent opioid misuse and accidental overdose is patient screening to identify those at risk. The purpose of our study was to determine whether such screening in community pharmacies led pharmacy personnel to intervene with patients at risk and to describe the proportion of patients they identified as at risk.
We implemented the Opioid and Naloxone Education (ONE) program in North Dakota to give community pharmacies and pharmacists training and tools to provide preventive screening for opioid misuse and accidental overdose before dispensing a prescribed opioid. Data were collected and analyzed from September 15, 2018, through May 15, 2021, to evaluate overall patient risk characteristics for opioid misuse and accidental overdose.
Of 8,217 patients screened, 3.9% were identified as at high risk for opioid misuse, and 18.3% at risk for accidental overdose. Nearly 1 of 3 screenings (31.7%) indicated opioid medication use in the past 60 days. Pharmacists delivered 1 or more risk-factor-dependent interventions to 41.1% of patients in the study. Following screening, naloxone dispensing in pharmacies increased to 6 times the national average.
Pharmacy-based patient screening for risk of opioid misuse and accidental overdose led to risk-dependent interventions targeted to individual patients. The tools and risk-dependent interventions applied in the ONE program increased patient awareness of opioid risks and ways to reduce risk. Future studies should examine long-term outcomes, including reduction in overdose, treatment of opioid use disorder, and reduced opioid-related acute care.
全美社区药店已采取新策略来应对阿片类药物泛滥问题。一种预防阿片类药物滥用和意外过量用药的策略是对患者进行筛选，以确定有风险的患者。我们的研究目的是确定社区药店的这种筛选是否会促使药店工作人员对有风险的患者进行干预，并描述他们确定为有风险的患者的比例。
我们在北达科他州实施了阿片类药物和纳洛酮教育（ONE）计划，为社区药店和药剂师提供培训和工具，以便在配药前对阿片类药物的滥用和意外过量用药进行预防性筛查。我们于 2018 年 9 月 15 日至 2021 年 5 月 15 日期间收集和分析数据，以评估总体患者阿片类药物滥用和意外过量用药的风险特征。
在 8217 名接受筛查的患者中，有 3.9%被确定为阿片类药物滥用的高危人群，18.3%有意外过量用药的风险。近三分之一（31.7%）的筛查表明过去 60 天内使用过阿片类药物。在研究中的患者中，41.1%的患者接受了一项或多项基于风险因素的干预措施。筛查后，药店纳洛酮的配药量增加到全国平均水平的 6 倍。
基于药店的患者筛查，以确定阿片类药物滥用和意外过量用药的风险，促使针对个别患者的风险依赖型干预措施。ONE 计划中使用的工具和风险依赖型干预措施提高了患者对阿片类药物风险以及降低风险的方法的认识。未来的研究应检查长期结果，包括减少过量用药、治疗阿片类药物使用障碍和减少与阿片类药物相关的急性护理。
