Objective: The objective for this paper is to report on the utility of the Opioid Risk Tool (ORT) to identify patients at elevated risk for opioid misuse and deliver medication safety-related services to them. Patient characteristics based on ORT risk stratification are also described.
Methods: Data from patients screened from September 17, 2018 to May 12, 2021 were descriptively evaluated for distribution of ORT scores, characteristics of patients stratified by ORT score, and services delivered to patients based on ORT score. The ORT generates a score from 0 to 26, with scores of 0-3, 4-7, and 8 or higher representing low, moderate, and high risk of opioid use disorder, respectively. Based upon screening results, pharmacists provided patient-specific education and interventions.
Results: A total of 6,460 patients were evaluated. Low, moderate, and high ORT scores were found among 87.5, 8.2 and 3.9% of the patients receiving opioids, respectively. Males comprised 46.1% of the patients, and 27.7% of the patients had received a prior opioid prescription in the last 60 days. As a result of risk stratification, the pharmacist explained opioid use disorder to 18.8, 36.1, and 47.0% of patients with low, moderate and high ORT scores, respectively (p < .001). High ORT scores were significantly associated with the pharmacist introducing the patient to community support services (OR = 2.35), the pharmacist having contacted their provider (OR = 6.41), male gender (OR = 2.06), and having taken an opioid in the last 60 days (OR = 1.76).
Conclusions: The ORT is a useful tool for opioid risk stratification of patients receiving opioid medications in the community pharmacy setting. Such stratification allows the pharmacist to provide individualized services to patients based on their risk profile.
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http://dx.doi.org/10.1016/j.sapharm.2022.07.009 | DOI Listing |
Br J Anaesth
January 2025
Department of Anesthesiology, Duke University School of Medicine, Durham, NC, USA; Bermaride LLC, Durham, NC, USA. Electronic address:
Background: Patients with obstructive sleep apnoea (OSA) are considered more sensitive to opioids and at increased risk of opioid-induced respiratory depression. Nonetheless, whether OSA treatment (continuous positive airway pressure, CPAP; or bilevel positive airway pressure, BIPAP) modifies this risk remains unknown. Greater opioid sensitivity can arise from altered pharmacokinetics or pharmacodynamics.
View Article and Find Full Text PDFReg Anesth Pain Med
January 2025
Division of Pain Management, University Hospitals, Cleveland, Ohio, USA.
Background: To provide recommendations on risk mitigation, diagnosis and treatment of infectious complications associated with the practice of regional anesthesia, acute and chronic pain management.
Methods: Following board approval, in 2020 the American Society of Regional Anesthesia and Pain Medicine (ASRA Pain Medicine) commissioned evidence-based guidelines for best practices for infection control. More than 80 research questions were developed and literature searches undertaken by assigned working groups comprising four to five members.
Approximately 800,000 total knee arthroplasties and 450,000 total hip arthroplasties are performed annually in the United States. These procedures provide significant pain relief and restore function in patients with advanced osteoarthritis, rheumatoid arthritis, and other degenerative joint conditions. Patient evaluation before surgery includes a history, physical examination, laboratory tests, and imaging.
View Article and Find Full Text PDFJ Psychiatr Pract
January 2025
Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA.
Insomnia, characterized by difficulty initiating or maintaining sleep, or poor sleep quality, is highly prevalent among individuals with substance use disorders (SUDs). The relationship between the 2 conditions is often bidirectional. We reviewed the impact of various substances (alcohol, stimulants, opioids, and cannabis) on sleep architecture and their potential to contribute to insomnia.
View Article and Find Full Text PDFJAMA Netw Open
January 2025
Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.
Importance: During buprenorphine treatment for opioid use disorder (OUD), risk factors for opioid relapse or treatment dropout include comorbid substance use disorder, anxiety, or residual opioid craving. There is a need for a well-powered trial to evaluate virtually delivered groups, including both mindfulness and evidence-based approaches, to address these comorbidities during buprenorphine treatment.
Objective: To compare the effects of the Mindful Recovery Opioid Use Disorder Care Continuum (M-ROCC) vs active control among adults receiving buprenorphine for OUD.
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