A community pharmacy intervention for opioid medication misuse: A pilot randomized clinical trial

• Published in: Journal of the American Pharmacists Association Vol. 58; no. 4; p. 395
• Main Authors: Cochran, Gerald, Field, Craig, Karp, Jordan, Seybert, Amy L, Chen, Qi, Ringwald, Whitney, Hruschak, Valerie, Chickering, Sunita, Kincman, Joelle, Jaber, Amanda, Tarter, Ralph
• Format: Journal Article
• Language: English
• Published: United States 01.07.2018
• Subjects: Analgesics, Opioid - adverse effects; Community Pharmacy Services; Drug Users; Humans; Medication Therapy Management; Patient Care - methods; Pharmacies; Pharmacists; Pilot Projects; Prescription Drug Misuse - adverse effects
• ISSN: 1544-3450
• DOI: 10.1016/j.japh.2018.03.005

Community pharmacy continues to play a crucial role in the national response to the opioid epidemic. The purpose of this article is to describe the protocol for a pilot study that is examining the feasibility and acceptability of the Motivational Intervention-Medication Therapy Management (MI-MTM) model. This study also examines the preliminary clinical effect of MI-MTM for improving opioid medication misuse and patient activation in self-management of health conditions that increase risk for misuse. MI-MTM is a pharmacy-based integrated care model made up of 4 evidence-based practices: medication therapy management; brief motivational intervention; patient navigation; and naloxone training and referral. To test MI-MTM compared with Standard Medication Counseling (SMC), we are conducting a 2-group randomized single-blinded controlled trial with assessments at 3 time points. The study is being conducted within a western Pennsylvania university-based community pharmacy with 46 patients with opioid misuse (MI-MTM = 23; SMC = 23). Feasibility will be measured by capturing patient completion rate of MI-MTM sessions. Acceptability will be measured by administering satisfaction surveys regarding pharmacist and patient navigator services. Acceptability will also be captured by conducting intensive qualitative interviews. Preliminary effect of the intervention on misuse will be measured with the use of the Prescription Opioid Misuse Index and the Opioid Compliance Checklist. Activation in self-management will be measured with the use of the Patient Activation Measure. This project is currently recruiting, and results are to come. This study is the first in the United States to implement an evidence-based integrated behavioral intervention into the community pharmacy setting to address opioid medication misuse among pharmacy patients. The results of this study will provide necessary foundational data that allow further testing of this intervention model in a larger trial.