NDSU Pharmacy is tackling the issue of addiction right where they have connections - with other pharmacists! They are going to engage community pharmacists in addressing the opioid crises in 3 ways;
1. Education on addiction related to opioid
2. Use of the Opioid Risk Tool (ORT), a 10 question screening survey for risk of addiction based on personal and family history
3. Strategies for subsequent engagement of patients on the safe use of these medications. Measure outcomes through a data management system.
Why is this needed? Opioid misuse disorder occurs among 23.7% of individuals filling an opioid prescription for pain (Jones et al. 2014), many of them completely unaware of their susceptibility; consequently, deaths from prescription opioid overdose have more than quadrupled since 1999 (CDC, 2016). It is imperative that opioid misuse prevention be moved further upstream, where the community pharmacist has the opportunity to screen patients for opioid misuse risk. When a patient is engaged in the conversation and admits to an opioid use disorder, the pharmacist can be supportive by offering resources to get help. All pharmacists will be licensed to provide naloxone to patients or their families.
The NDSU team has designed and pilot-tested a 3-hour training curriculum on opioid risk screening and patient care, which will be available more widely because it is on-line. It has been piloted with 11 pharmacists in their community pharmacies. The next step and the goal of this project is to offer the “Opioid Misuse Risk Prevention” toolkit to all pharmacists in Cass County and eventually beyond.
In the pilot, the tool worked to identify an individual’s risk of misusing opioid prescription medication, triage patients, and provide patient counseling and referral.
The training also promotes those supporting services such as medication take-back programs, naloxone prescribing, and partial fills (ND law recently changed to allow pharmacists to fill only a portion of the prescription with the patient still being able to return if the opioid was still needed.
NDSU is working with North Dakota Quality Health Associates to build an electronic data management system for pharmacists to track outcomes. This data will be a “report card” to assess the work.