Shared Decision-Making Improves Opioid Stewardship Programs

Considering the subjective and variable nature of pain, emerging opioid stewardship programs should consider shared decision-making in analgesic selection and a central role for pharmacists in the process, according to study findings published in the Journal of the American Pharmacists Association.

“Pharmacists have extensive knowledge of analgesic medications and are best equipped not only to detect inappropriate opioid prescriptions but also to educate patients and clinicians regarding appropriate opioid use,” wrote study authors.

Patients and prescribers may have different expectations for pain relief as well as different prioritizations when it comes to side effects. For example, some patients may opt for an analgesic that causes the least disruption in their daily lives, while providers may pursue a higher level of pain relief. Shared decision-making positions opioid stewardship programs to navigate such issues routinely and, in effect, curb misuse and achieve relief in line with patient values.

“Given their expertise, pharmacists are well positioned to discuss and optimize analgesic selection to fit each individual patient’s needs,” stated study authors.

Lack of time and a lack of teamwork with providers, however, are among documented challenges that get in the way of pharmacist-patient therapeutic alliance. Nevertheless, if health systems can address such barriers, they will likely reap the benefits of an effective process preferred by many patients, according to researchers.

The authors cited a study that showed pharmacist-led shared decision-making improved medication adherence and treatment satisfaction in patients with major depressive disorder.

“To be successful, strong communication and buy-in are needed from a range of health professionals,” concluded study authors. “Pharmacists are in one of the best positions to be able to discuss different analgesic options with patients, help empower them to participate in their care, and facilitate shared decision-making.”

Reference:
Xu K, Nolan S, Mihic T, Ti L. Improving opioid stewardship programs through shared decision-making. J American Pharm Assoc. Published online February 7, 2022. doi:10.1016/j.japh.2022.02.001