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Current state of opioid stewardship
L Diana Ardeljan1, Julie M Waldfogel2, Mark C Bicket3
1Department of Pharmacy, The Johns Hopkins Hospital, Baltimore, MD, and Department of Pharmacy, University of Maryland Medical Center, Baltimore, MD.
Many hospitals lack opioid stewardship programs and prospective screening for opioid-related adverse events (ORAEs). Improving these practices, alongside specialist access, can enhance safe opioid use.
Area of Science:
- Pharmacology
- Healthcare Management
- Patient Safety
Background:
- The opioid epidemic causes significant harm, with hospital-related adverse events being a major concern.
- Opioid stewardship programs are crucial for safe and rational opioid prescribing, aligning with Joint Commission standards.
Purpose of the Study:
- To determine the prevalence of current hospital practices aimed at improving opioid utilization.
- To assess the adoption of opioid stewardship programs and related safety measures in hospitals.
Main Methods:
- A cross-sectional survey was electronically distributed to 133 hospitals in March 2018.
- The survey examined opioid stewardship programs, formulary restrictions, specialist involvement, risk factor screening, and educational initiatives.
Main Results:
- Only 23% of hospitals had an opioid stewardship program, and 14% used prospective screening for opioid-related adverse events (ORAEs).
- Variability existed in ORAE risk factor screening; formulary restrictions were opioid- and formulation-dependent.
- Most hospitals had pain management (90%) or palliative care services (67%).
Conclusions:
- A significant gap exists in hospital opioid stewardship and prospective ORAE screening.
- Hospitals can improve opioid safety by implementing best practices, including specialist access and robust monitoring systems.
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