Overview
- A pharmacy team at a Pharmacy Controlled Substance Clinic (PCSC) implemented a multidisciplinary stewardship program based on CDC guidelines to help resident physicians monitor high-risk patients receiving opioid medications for chronic nonmalignant pain (CNCP).
Organization Name
University of California Davis
Organization Type
- Academic Medical Center
Team Members Involved
- Pharmacist
- Physicians
Workflow Steps
Intervention: The intervention consisted of the creation of an annual urine drug screen (UDS), a quarterly review of a prescription drug monitoring program (CURES), an annual patient-provider agreement (PPA), and a document evaluating quarterly use of opioids. This intervention allowed providers to apply CDC guidelines and assess risk factors for opioid-related harms while monitoring high-risk patients who were prescribed opioids for CNCP.
Process: Patients were first screened before being included in the intervention. The inclusion criteria included receiving opioid prescriptions and experiencing chronic nonmalignant pain (CNCP), and the exclusion criteria included aberrant opioid use behaviors, being less than 18 years of age, and experiencing malignancy-related pain. The pharmacy team then outlined various measures that resident physicians would incorporate in their monitoring of these patients with CNCP. These measures included signing an annual patient provider agreement (PPA), performing an annual urine drug screen (UDS), reviewing a prescription drug monitoring program (CURES) quarterly, and evaluating opioid use quarterly.
Lessons: This intervention led by the pharmacy team allowed resident physicians to better implement CDC guidelines to monitor patients with CNCP. The pharmacy team was able to incorporate measures into a program to better observe CDC guidelines, and thus improve the safety of opioid prescribing in patients with CNCP within an academic primary care setting.
Sources
Hellier, Y., Wilson, M., Leahy, A., Burnham, K. Pharmacy multidisciplinary stewardship program for high-risk patients prescribed opioids in an academic clinic. J Opioid Manag 16(5), 341-350. 2020.