Current state of opioid stewardship. (1st April 2020)
- Record Type:
- Journal Article
- Title:
- Current state of opioid stewardship. (1st April 2020)
- Main Title:
- Current state of opioid stewardship
- Authors:
- Ardeljan, L Diana
Waldfogel, Julie M
Bicket, Mark C
Hunsberger, Joann B
Vecchione, Tricia Marie
Arwood, Nicole
Eid, Ahmed
Hatfield, Laura A
McNamara, LeAnn
Duncan, Rosemary
Nesbit, Todd
Smith, Jacob
Tran, Jackie
Nesbit, Suzanne A - Abstract:
- Abstract: Purpose: The opioid epidemic continues to result in significant morbidity and mortality even within hospitals where opioids are the second most common cause of adverse events. Opioid stewardship represents one model for hospitals to promote safe and rational prescribing of opioids to mitigate preventable adverse events in alliance with new Joint Commission standards. The purpose of this study was to identify the prevalence of current hospital practices to improve opioid use. Methods: A cross-sectional survey of hospital best practices for opioid use was electronically distributed via electronic listservs in March 2018 to examine the presence of an opioid stewardship program and related practices, including formulary restrictions, specialist involvement for high-risk patients, types of risk factors screened, and educational activities. Results: Among 133 included hospitals, 23% reported a stewardship program and 14% reported a prospective screening process to identify patients at high risk of opioid-related adverse events (ORAEs). Among those with a prospective screening process, there was variability in ORAE risk factor screening. Formulary restrictions were dependent on specific opioids and formulations. Patient-controlled analgesia was restricted at 45% of hospitals. Most hospitals reported having a pain management service (90%) and a palliative care service providing pain management (67%). Conclusion: The absence of opioid stewardship and prospectively screeningAbstract: Purpose: The opioid epidemic continues to result in significant morbidity and mortality even within hospitals where opioids are the second most common cause of adverse events. Opioid stewardship represents one model for hospitals to promote safe and rational prescribing of opioids to mitigate preventable adverse events in alliance with new Joint Commission standards. The purpose of this study was to identify the prevalence of current hospital practices to improve opioid use. Methods: A cross-sectional survey of hospital best practices for opioid use was electronically distributed via electronic listservs in March 2018 to examine the presence of an opioid stewardship program and related practices, including formulary restrictions, specialist involvement for high-risk patients, types of risk factors screened, and educational activities. Results: Among 133 included hospitals, 23% reported a stewardship program and 14% reported a prospective screening process to identify patients at high risk of opioid-related adverse events (ORAEs). Among those with a prospective screening process, there was variability in ORAE risk factor screening. Formulary restrictions were dependent on specific opioids and formulations. Patient-controlled analgesia was restricted at 45% of hospitals. Most hospitals reported having a pain management service (90%) and a palliative care service providing pain management (67%). Conclusion: The absence of opioid stewardship and prospectively screening ORAEs represents a gap in current practice at surveyed hospitals. Hospitals have an opportunity to implement and refine best practices such as access to pain management specialists, use of formulary restrictions, and retrospective and prospective monitoring of adverse events to improve opioid use. … (more)
- Is Part Of:
- American journal of health-system pharmacy. Volume 77:Number 8(2020)
- Journal:
- American journal of health-system pharmacy
- Issue:
- Volume 77:Number 8(2020)
- Issue Display:
- Volume 77, Issue 8 (2020)
- Year:
- 2020
- Volume:
- 77
- Issue:
- 8
- Issue Sort Value:
- 2020-0077-0008-0000
- Page Start:
- 636
- Page End:
- 643
- Publication Date:
- 2020-04-01
- Subjects:
- formulary restrictions -- opioid-related adverse events -- opioid risk factors -- opioid safety -- opioid stewardship -- pain management
Hospital pharmacies -- United States -- Periodicals
615.1 - Journal URLs:
- https://academic.oup.com/ajhp ↗
http://www.oxfordjournals.org/ ↗ - DOI:
- 10.1093/ajhp/zxaa027 ↗
- Languages:
- English
- ISSNs:
- 1079-2082
- Deposit Type:
- Legaldeposit
- View Content:
- Available online (eLD content is only available in our Reading Rooms) ↗
- Physical Locations:
- British Library DSC - BLDSS-3PM
British Library HMNTS - ELD Digital store - Ingest File:
- 15067.xml