Pharmacist-led Opioid Deprescribing Pilot Clinic within Outpatient Palliative Care

IF 3.5 2区医学 Q2 CLINICAL NEUROLOGY

Journal of pain and symptom management Pub Date : 2025-07-30 DOI:10.1016/j.jpainsymman.2025.07.020

Maria Felton Lowry PharmD, BCPS, BCGP , Sydney Lee PharmD , Makayla F. Hoke PharmD , Emily R. Leung PharmD , Hailey Roup PharmD , Hope E. Linge , Linda King MD , Yael Schenker MD, MAS, FAAHPM

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引用次数: 0

Abstract

Background

Patients with cancer receiving opioid therapy often follow with specialty palliative care after achieving remission. Strategies to reduce risks associated with ongoing opioid therapy in survivorship are needed.

Measures

Feasibility, safety, and impact.

Intervention

A pharmacist-led opioid deprescribing program, embedded within a specialty palliative care clinic, was designed for patients on long-term opioid therapy who have reached cancer remission.

Outcomes

In the nine-month pilot phase, 80% of referred patients established care with the pharmacist. One hundred seventeen pharmacist visits occurred: 20 in person, 52 telemedicine, and 45 telephone. The pharmacist spent an average of 72 minutes for initial and 45 minutes for follow-up visits. Oral morphine equivalents (OMEs) were reduced for 75% of referred patients, with an average of 22% reduction. No patients were hospitalized for uncontrolled pain or withdrawal.

Conclusion/Lessons learned

Opioid deprescribing clinic was time-intensive and patients required close monitoring for implementation of patient-specific opioid deprescribing plans.

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药剂师主导的阿片类药物处方在门诊姑息治疗试点诊所。

背景：接受阿片类药物治疗的癌症患者通常在获得缓解后接受专科姑息治疗。需要采取策略来降低与正在进行的阿片类药物治疗相关的生存风险。措施：可行性、安全性和影响干预：一个由药剂师主导的阿片类药物处方项目，嵌入专科姑息治疗诊所，设计用于长期阿片类药物治疗已达到癌症缓解的患者。结果：在9个月的试点阶段，80%的转诊患者与药剂师建立了护理。共进行了117次药剂师访问：20次亲自访问，52次远程访问，45次电话访问。药剂师初次就诊平均花费72分钟，随访平均花费45分钟。75%的转诊患者口服吗啡当量（OMEs）减少，平均减少22%。没有患者因无法控制的疼痛或戒断而住院。结论/经验教训：阿片类药物处方减少门诊是时间密集型的，患者需要密切监测以实施针对患者的阿片类药物处方减少计划。关键信息：本文描述了在姑息治疗门诊内药剂师主导的阿片类药物处方倡议的发展和实施。在试验阶段，大多数患者口服吗啡当量减少，减量决定是根据患者的需要个性化的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of pain and symptom management 医学-临床神经学

CiteScore

8.90

自引率

6.40%

发文量

821

审稿时长

26 days

期刊介绍： The Journal of Pain and Symptom Management is an internationally respected, peer-reviewed journal and serves an interdisciplinary audience of professionals by providing a forum for the publication of the latest clinical research and best practices related to the relief of illness burden among patients afflicted with serious or life-threatening illness.