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Home care clients have safety barriers related to medication storage, disposal, and safe use of opioids. Limited research is available regarding medication safety initiatives in the home care setting. This study evaluates a medication safety initiative, linked with opioid misuse and overdose prevention screening, for home care clients with different levels of service. Training and screening tools designed for community pharmacies by the Opioid & Naloxone Education (ONE) Program were modified for use by home health nurses. All new admits to the home health services were screened for medication storage, medication disposal, and use of pain medications. Patients taking opioids were screened for opioid-specific risks. Interventions based on screening results included education, provision of medication lock boxes, drug disposal packets, and/or naloxone. Most home care clients (85%) are properly storing their medication and 38% were not properly disposing unused medications. Higher levels of care had greater pain medication needs, including the provision of naloxone. This study demonstrates the opportunity to incorporate medication safety screening into nursing home health visits., (© 2023 Wiley Periodicals LLC.)

Pharmacists tend to provide care to patients with psychiatric disorders less frequently than to other types of patients, yet patients with psychiatric disorders experience more drug-related problems and use more opioids than those without psychiatric disorders. The Opioid and Naloxone Education (ONE) program equipped pharmacists to screen for opioid misuse and overdose risk and to implement a set of interventions for any patient filling an opioid prescription. Patients with a psychiatric disorder (N=1,980; 24.1% of those screened) were significantly more likely to receive more than one intervention from a ONE program pharmacist than were those without a psychiatric disorder. The use of an objective screening tool and training in stigma reduction and nonjudgmental communication approaches, which are part of the ONE program process, deserve further exploration as ways to increase the frequency of pharmacist-provided education and other critical interventions for patients with psychiatric disorders.

Objective: Opioid and Naloxone Education (ONE Rx) is a program that focuses on community pharmacy-based patient screening and interventions to improve population health with regard to opioid use. The objective for this paper is to describe how ONE Rx was implemented, report on the populations impact using the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) Model, and explain future implications of the program., Methods: ONE Rx is a statewide program in which pharmacists screen patients who receive an opioid prescription for the risk of opioid misuse and accidental overdose. The five domains of the RE-AIM Model were used to evaluate ONE Rx. Reach was defined as the proportion of patients receiving opioid prescriptions who completed the screening. Efficacy was defined as the proportion of individuals identified as at risk of opioid misuse or accidental overdose and who received a pharmacist intervention. Adoption was defined as the proportion of eligible community pharmacies who enrolled in ONE Rx. Implementation was defined as the proportion of pharmacies that enrolled in ONE Rx that provided at least five patient screenings. Maintenance was defined as the proportion of pharmacies that adopted ONE Rx that completed at least one screening three months after the initial provision., Results: Approximately 16.9% of all patients receiving opioid prescriptions were screened for risk of opioid misuse and accidental overdose. Of the patients screened, 97.1% of patients at risk for opioid misuse or accidental overdose received a pharmacist-led intervention. Additionally, 44.8% of the pharmacist that enrolled in ONE Rx completed at least five screenings and of those, 80.0% maintained the program three months later., Conclusions: ONE Rx demonstrated success and positive population impact. The RE-AIM Model identified strength in the areas of efficacy, adoption and maintenance, and the need for improvement in the areas of reach and implementation., (Copyright © 2019 Elsevier Inc. All rights reserved.)