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What predicts pharmacists’ engagement with opioid‑outcome screening? Secondary analysis from an implementation study in community pharmacy

Nielsen, S, Sanflippo, P, Picco, L, Bruno, R ORCID: 0000-0001-6673-833X, Kowalski, M, Wood, P and Larney, S 2020 , 'What predicts pharmacists’ engagement with opioid‑outcome screening? Secondary analysis from an implementation study in community pharmacy' , International Journal of Clinical Pharmacy , doi: 10.1007/s11096-020-01074-5.

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Abstract

Background Pharmacists have a key role to play in identifying and responding to emerging clinical problems with prescribedopioids. A pilot study in Australia examined the implementation of screening and brief intervention (Routine Opioid OutcomeMonitoring [ROOM]) to identify and respond to opioid-related problems in community pharmacies. In this implementation study, the rate of screening varied considerably between pharmacies. Objective The aim of this study was to examinepharmacist characteristics associated with implementation of ROOM. Setting Community pharmacies in Victoria and NewSouth Wales, Australia. Methods We implemented a validated computer-facilitated screening (ROOM), combined with briefintervention for opioid-related problems based on a widely accepted framework for monitoring outcomes. In this analysis,we examined the correlates of ROOM completion for individual pharmacists. Negative binomial regression was used toidentify baseline predictors of greater screening, with the number of ROOM screens as the dependent (outcome) variable andpharmacist demographics, knowledge, confidence and comfort responding to prescription opioids problems, and attitudestowards evidence based practice examined as independent (predictor) variables. Main outcome measure Number of screenscompleted by an individual pharmacist as reported in follow-up surveys by pharmacist. Results Fewer years of practice wasassociated with a greater number of screenings conducted. On average, each additional decade of practice was associatedwith a 31% (95% CI 0%, 53%) reduction in the number of screenings undertaken by pharmacists. A multivariable analysisrevealed that each additional decade practicing, lower knowledge of naloxone and lower confidence in identifying unmanaged pain were all independently associated with reduced engagement in screening after controlling for other variables.Conclusion Findings from this pilot study identified potential barriers to implementing opioid outcome monitoring. Furtherstudies could test different groups of community pharmacists’ experience of different barriers when implementing monitoring outcomes with prescribed opioids, to inform future implementation and clinical practice.

Item Type: Article
Authors/Creators:Nielsen, S and Sanflippo, P and Picco, L and Bruno, R and Kowalski, M and Wood, P and Larney, S
Keywords: pharmacist, pharmaceutical opioid dependence, community pharmacy, implementation, opioids, overdose, naloxone, pharmacy practice, Australia
Journal or Publication Title: International Journal of Clinical Pharmacy
Publisher: Springer Netherlands
ISSN: 2210-7703
DOI / ID Number: 10.1007/s11096-020-01074-5
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Copyright 2020 Springer Netherlands

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