Paula Newman, clinical pharmacist and research specialist at Northwest Telepharmacy Solutions, led a successful project to evaluate the feasibility and effectiveness of a remote pharmacist-led Opioid Stewardship Program (OSP) for chronic non-cancer pain (CNCP). Using videoconferencing (VC) technology, she was able to do this in a region without access to a specialized clinician in CNCP.
With support from the Canadian Foundation for Pharmacy’s Innovation Fund, Newman and her team conducted their pilot study between March 2019 and January 2021 with a medical care team that included physicians, nurses, and allied health professionals, located in northeastern Ontario near two First Nations reservations.
The study not only demonstrated the feasibility of a remote pharmacist-led OSP using VC technology, but “it also established that the program, which enabled a pharmacist to provide support and recommendations for patients and their providers, was well received and that recommendations made by a pharmacist have a high acceptance rate,” says Newman.
Prescribers reported that patients felt good about being contacted by the OSP pharmacist for medication reviews and discussions centred upon their health. For their part, prescribers were able to refresh their knowledge on chronic pain opioid management and increase use of the program as new patients were initiated on the treatment. They were interested in continuing the program and implementing aspects of the OSP in their practice where they were lacking previously, and recommended that OSP involvement in patient consultations and participation in multidisciplinary discussions that may involve opioid therapy be increased.
Plans are in place to expand the program to another remote Family Health Team (FHT), but due to changes in both administration and physicians, they are on hold until those positions are filled. Meanwhile, the company continues to provide patient counseling, education, drug information, medication management and opioid stewardship for the pilot FHT.
“Northwest Telepharmacy Solutions is always open to OSP expansion, in the community and in hospitals,” says Newman. “There is a need for FHTs to identify opioid stewardship as a priority and acquire the needed funding to support the Program.” Newman says the team is awaiting the revised Accreditation Canada Required Organizational Practices for opioid stewardship to identify opportunities to introduce the OSP in hospitals as well.
“As the opioid crisis continues, patient harm and lives lost daily are causing a tremendous burden on families, communities and healthcare systems,” she says. “This virtually delivered pharmacist-led OSP, and its affiliated components, holds promise as a potentially feasible and effective intervention in other remote and rural Canadian communities that have limited or no access to CNCP opioid stewardship expertise.” For more information on the program here.
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