Enhancing Perioperative Prescription Opioid Risk Mitigation Through Pharmacist Intervention

Prescription opioid risk mitigation is paramount to patient and community safety. Postoperative pain management prescriptions can lead to excess opioids in the home with many patients being unaware of proper disposal. The purpose of this initiative was to evaluate pharmacist impact on opioid safety outcomes in perioperative surgical pain management patients. Select patients scheduled to undergo total knee arthroplasty or total hip arthroplasty at a single Veterans Affairs Health Care System were contacted perioperatively by a clinical pharmacist to provide education on pain management and prescription opioid risk mitigation. Outcomes measured included patient interest in a naloxone prescription and medication disposal envelopes, level of pain control, quantity of opioids used, method of disposal or planned disposal of remaining opioids, and patient satisfaction. Twenty-seven patients were included in the initiative. Twenty patients (74%) expressed interest in a naloxone prescription and 13 patients (48%) expressed interest in a medication disposal envelope. During the postsurgery assessment, 20 patients reported having excess opioid tablets. Of those, 4 patients (20%) reported proper disposal of excess opioids, and 16 patients (80%) had not yet disposed of their excess opioids. Pharmacist involvement in perioperative pain management could promote prescription opioid risk mitigation through targeted education and the proffering of tools such as naloxone and medication disposal options.