Risk-based strategy for outpatient pharmacy practice: Focus on opioids

To highlight the limitations of community pharmacy practice and to propose a system change by implementing a risk-assessment method and management strategy for opioids in this arena.

Selected by the author.

Numerous studies show that the U.S. health care system is subject to a high rate of drug misadventures involving primarily low therapeutic index drugs, especially opioids. Currently proposed approaches to managing opioids focus on access control, but without a broader consideration of patient-use problems that lead to morbidity and mortality. While pharmacists are well-trained health professionals, their primary focus has been on drug distribution rather than proper use. This article highlights the limitations in contemporary community pharmacy practice that likely contribute to the problem of opioid misuse and resultant morbidity.

A new model of practice is proposed whereby the most dangerous agents such as opioids are preidentified for a more formalized risk-based strategy focused upon optimal patient education and required follow-up.