Portland, Oregon — In a telling new study, pre- and post-surgical efforts by pharmacists yielded staggering effects on patient opioid use. Led by Kaiser Permanente, the healthcare giant with a suite of managed-care services, the study followed almost 600 patients undergoing orthopedic surgery. Half of them benefited from a triple-tiered pharmacist intervention.
First, prior to surgery, they received a brochure, from their pharmacists, illuminating various facets of pain management, including what they might expect to experience after their operations and what constituted appropriate use of prescribed opioids. Subsequently, right after the surgery, these patients were sent more detailed and practical information about assessing their current pain and using their medications prudently.
What came last was perhaps most critical. Those patients who filled a prescription for opioids more than 28 days after their surgeries received a follow-up phone call from their pharmacists. Pharmacists were exceptionally prepped with not just in-depth information about recommended usage but also customizable motivational strategies. They engaged patients in serious discussion to drive home best practices and detect any potential problems.
With patients who had undergone hip-replacement surgeries, the results were significant and promising. Patients who had pharmacist support displayed median opioid use about half as high as those patients in the control group. These results were published last week in The American Journal of Managed Care, and the clinical implications are fairly straightforward.
“Previous research has shown that once patients use opioid therapy for 90 days, they’re more likely to keep using it for years,” says Dr. David Smith, the lead author of Kaiser Permanente’s study. “Our study showed that by identifying the patients at highest risk and reaching out to them with educational material and specialized, targeted telephone support, we can successfully encourage them to reduce their immediate post-surgical opioid use, potentially mitigating the risk of longer-term use.”
Why This Matters
Often an overlooked resource in the United States, pharmacists are finding their roles expanding as they attend in new ways to a variety of problems, especially medication adherence. Strategic partnerships with pharmacists can save time and money and yield innovative and life-changing health care services.