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Analysis

Enlist Pharmacists to Help Lead Opioid Stewardship at Your Hospital

By Christopher Cheney  
   July 15, 2019

New research shows an increasing number of hospitals are relying on pharmacists to monitor drug therapy and prevent opioid abuse.

More hospitals are routinely assigning pharmacists to conduct drug therapy management, according to a recent national survey.

The survey, which was conducted by the American Society of Health-System Pharmacists (ASHP), focused on medication management activities, which have a major impact on patient safety and clinical care such as medication monitoring, reporting and monitoring of adverse drug events, and patient counseling.

"Pharmacists continue to improve drug therapy monitoring for patients in U.S. hospitals. They are also responding to public health issues related to medication use. These advancements include taking an active role in opioid stewardship programs," the survey report says.

The 2018 survey, which features responses from pharmacy directors at more than 800 hospitals, generated several key data points:

  • The percentage of hospitals that have pharmacists monitoring at least 75% of patients has increased from 20.3% in 2000 to 60.9% in 2018.
     
  • Pharmacists monitored all patients at 33.0% of hospitals in 2018.
     
  • Abnormal laboratory results that prompted dosage adjustments were the most common factor spurring patient monitoring by pharmacists (80.0% of hospitals).
     
  • Other factors that led to pharmacist monitoring of patients included formalized lists that required patient monitoring (74.8% of hospitals), disease state (54.1%), surgical services (51.1%), patients taking medications that were in shortage (40.1%), and high-cost medications (38.1%).
     
  • There was an active opioid stewardship program at 40.9% of hospitals.
     
  • At 97.4% of hospitals with an opioid stewardship program, pharmacists played an active role in the programs such as prescribing support.

A co-author of the survey report told HealthLeaders that pharmacists are playing a crucial role in medication management in the hospital setting. "Pharmacists are increasingly managing medication therapy, including selecting appropriate drug therapies, monitoring patients and assessing outcomes, and educating patients and other providers," said Michael Ganio, PharmD, MS, director of pharmacy practice and quality at ASHP.

Hospital pharmacists helping to tackle opioid abuse epidemic
 

Hospital pharmacists have helped manage antibiotics stewardship programs for years, and they are increasingly being called upon to help manage opioid stewardship programs, Ganio said. "This survey shows that pharmacists are also being looked to as leaders in addressing the opioid crisis by implementing similar stewardship programs designed to ensure the appropriate use of opioids and to prevent and detect opioid diversion."

Hospital pharmacists are uniquely qualified to curb opioid diversion, he said. "Through diversion prevention and detection programs, pharmacists can ensure the supply of opioids are used appropriately and prevent misuse through diversion."

Opioid stewardship programs benefit from hospital-pharmacist leadership, Ganio said. "Pharmacists are the medication experts and can ensure that opioid use in hospitals is optimal, safe, and effective. By engaging the interprofessional team, pharmacists can educate providers and establish guidelines for opioid use. Pharmacists can also use data from prescription drug monitoring databases to track prescribing practices and patient behaviors that can lead to abuse."

Christopher Cheney is the senior clinical care​ editor at HealthLeaders.


KEY TAKEAWAYS

The percentage of hospitals that have pharmacists monitoring at least 75% of patients has increased from 20.3% in 2000 to 60.9% in 2018, a recent survey found.

Pharmacists monitored all patients at 33.0% of hospitals in 2018.

Pharmacists are playing a leadership role in hospital opioid stewardship programs.

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