Implementation of a pharmacy consult to reduce co-prescribing of opioids and benzodiazepines in a Veteran population
| Autor: | Dana Chiulli, Lacey Miller, Deborah Pardo |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Adolescent Databases Factual Population Medicine (miscellaneous) Pharmacy Drug overdose 03 medical and health sciences Patient safety Benzodiazepines Young Adult 0302 clinical medicine medicine Humans 030212 general & internal medicine Prior authorization Medical prescription education Referral and Consultation Retrospective Studies Veterans education.field_of_study business.industry Middle Aged medicine.disease Mental health Substance abuse Analgesics Opioid Hospitalization Psychiatry and Mental health Drug Therapy Combination Female Medical emergency Drug Overdose business Pharmacy Service Hospital 030217 neurology & neurosurgery |
| Zdroj: | Substance abuse. 38(2) |
| ISSN: | 1547-0164 |
| Popis: | Background: The dangers of co-administration of opioid pain relievers (OPRs) and benzodiazepines (BZDs) are well documented. The combination of OPRs and BZDs make up the majority of medications involved in prescription drug–related overdose and are often used concomitantly. This pattern is consistent among the veteran population where mental health illness and substance abuse are prominent. The Veterans Health Administration implemented the Opioid Safety Initiative (OSI) aimed at improving patient safety surrounding OPRs. In alignment with OSI, the study facility implemented a prior authorization pharmacy consult in an effort to reduce OPR and BZD co-prescribing and optimize patient safety. The purpose of this article is to report the frequency of co-prescribing before and after implementation of the consult. Secondary aims include reporting the emergency room visits and hospitalizations, prescribers’ actions in the setting of disapproved consults, patient characteristics associated with co-prescribing, and frequency of co-prescribing without a consult. Methods: This was a single-center, retrospective chart review study. Microsoft Structured Query Language server database and Veterans Health Information Systems and Technology Architecture were used to extract data and identify study patients. The Computerized Patient Record System was used to collect patient data. Microsoft Access and Excel were utilized to organize, query, and analyze the extracted data. Results: There was a 34.6% reduction in patients on chronic OPR therapy co-prescribed a BZD, and the total number of overdose-related events decreased after implementation of the consult. In the event of disapproved consults, pharmacists’ evidence-based recommendations were implemented 63% of the time. Patients for whom co-prescribing consults were placed were more likely to have mental health diagnoses. Conclusions: Following implementation of a pharmacy consult, there was a reduction in co-prescribing and overdose-related events at the study facility. |
| Databáze: | OpenAIRE |
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