Routine opioid outcome monitoring in community pharmacy: outcomes from an open-label single-arm implementation-effectiveness pilot study

Background: In response to rising harms with prescription opioids, recent attention has focused on how to better utilise community pharmacists to monitor outcomes with opioid medicines.

Methods: Community pharmacies in Victoria and New South Wales, Australia, were recruited to an open-label single-arm observational implementation-effectiveness pilot study. Pharmacists completed baseline and follow up interviews to measure change in knowledge and confidence following training on, and implementation of ROOM. Paired t-tests compared pre-post scores. Patients that participated were invited to complete a brief evaluation survey. Measures of feasibility and acceptability were collected.

Results: Sixty-four pharmacists from 23 pharmacies were recruited and trained to conduct ROOM. Twenty pharmacies (87%) were able to implement ROOM, with four pharmacies completing the target of 20 screens. Pharmacists completed ROOM with 152 patients in total. Forty-four pharmacists provided baseline and follow-up data which demonstrated significant improvements in confidence identifying and responding to unmanaged pain, depression and opioid dependence. Despite increases, low to moderate confidence for these domains was reported at follow-up. Responses from pharmacists and patients indicated that implementation of ROOM was feasible and acceptable.

Conclusions: Pharmacists' confidence in identifying and responding to opioid-related problems significantly increased from baseline to follow up across several domains, however scores indicated that there is still significant scope to further increase confidence in responding to opioid-related problems. ROOM is feasible and acceptable, though more extensive pharmacist training with opportunity to practice skills may assist in developing confidence and skills in this challenging clinical area.