Including Pharmacists on Interdisciplinary Health Care Teams Can Combat Opioid Abuse

As health care systems increasingly look to interdisciplinary approaches amidst the opioid abuse epidemic, allowing pharmacists to play a larger role on the health care team can reduce opioid use among patients with chronic pain, according to a study presented at PainWeek 2017 in Las Vegas.¹

The study, conducted at the San Francisco Veterans Affairs Health Care System, evaluated the opioid use of 162 patients with chronic pain who either received usual primary care or were treated by an integrated pain team (IPT) consisting of a medical provider, a pain pharmacist, and a pain psychologist.

After 3 months, the researchers determined that patients who were treated by the IPT experienced a 61% greater reduction in morphine equivalent daily dose (MEDD) than those who received usual care group. The effects of an interdisciplinary health care team were even more profound after 6 months, as those in the IPT group experienced a 103% greater MEDD reduction than those in the usual care group.

Additionally, those in the IPT group were found to be 3 times as likely to achieve a 50% or greater reduction in opioid dose after 6 months than those in the usual care group.

“An interdisciplinary biophysical pain care team, embedded in primary care decreases opioid use and improves opioid safety in veterans with chronic pain and opioid misuse,” the study authors concluded. “Implementation of dissemination of IPT-like models in other health care systems may lead to system-wide improvements in opioid risk reduction.”

Acknowledging that that the majority of the study participants were male veterans, the study authors noted that further research is needed to assess the benefits of an IPT among the general population. However in an interview at the meeting, clinical pharmacy specialist Jeffrey Fudin, PharmD, expressed hope that the expansion of the pharmacist’s role would allow physicians to more effectively combat opioid abuse and improve patient health.

“PharmDs and MDs bring equal and sometimes opposite knowledge to the table, and it is very important for all of the specialties to work together,” Dr. Fudin, who is also a regular contributor to this website, told Pharmacy Times. “Throughout the opioid abuse epidemic, there have been very few government organizations that have included pharmacists as part of their panels to develop policies for drugs. One very obvious solution is to give pharmacist provider status and create a mechanism by which they can be paid so that physicians can utilize their expertise.”

Reference

• Rife T, Tighe J, Li Y, Seal K. Improving Chronic Pain Care and Opioid Safety in VA Primary Care: Implemetnation and Evaluation of the Integrated Pain Team Clinic. Presented at: PainWeek 2017. September 5-9, 2017. Las Vegas.