Medication Safety and Opioid Risk Screening Program Delivered by Community Paramedics
Main Article Content
Abstract
Objective:
To describe the program and associated outcomes of an innovative medication safety and opioid risk screening program delivered by community paramedics
Methods:
The study was conducted within a health system community paramedic program in North America. Community paramedics employed a medication safety questionnaire and opioid risk assessment tool during home visits, offering tailored interventions based on individual patient risks. Data collection and analysis were facilitated through REDCap and the health system’s electronic health record.
Results:
Analysis of 435 patient screenings revealed notable findings. A meaningful portion of patients used opioids for pain management, with a subset identified at high risk for opioid misuse or overdose. While most patients stored medications safely, disposal practices varied, highlighting a need for education and intervention. Discrepancies in service provision between service areas identified multiple possible barriers and solutions.
Conclusion:
This research underscores the importance of proactive medication safety measures within community paramedicine and provides an example of a community paramedic program designed around community-based need, stakeholder collaboration, and program evaluation. Future efforts should focus on improving data collection methods, and advocating for sustainable funding to support comprehensive intervention strategies aimed at enhancing patient safety and well-being.
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References
Achana, F. A., Sutton, A. J., Kendrick, D., Wynn, P., Young, B., Jones, D. R., Hubbard, S. J., & Cooper, N. J. (2015). The Effectiveness of Different Interventions to Promote Poison Prevention Behaviours in Households with Children: A Network Meta-Analysis. PLOS ONE, 10(4), e0121122. https://doi.org/10.1371/journal.pone.0121122
Agarwal, G., Angeles, R., Pirrie, M., McLeod, B., Marzanek, F., Parascandalo, J., & Thabane, L. (2018). Evaluation of a community paramedicine health promotion and lifestyle risk assessment program for older adults who live in social housing: A cluster randomized trial. CMAJ: Canadian Medical Association Journal = Journal de l’Association Medicale Canadienne, 190(21), E638–E647. https://doi.org/10.1503/cmaj.170740
Bennett, K. J., Yuen, M. W., & Merrell, M. A. (2018). Community Paramedicine Applied in a Rural Community. The Journal of Rural Health: Official Journal of the American Rural Health Association and the National Rural Health Care Association, 34 Suppl 1, s39–s47. https://doi.org/10.1111/jrh.12233
Bolster, J., Armour, R., O’Toole, M., Lysko, M., & Batt, A. M. (2023). The paramedic role in caring for people who use illicit and controlled drugs: A scoping review. Paramedicine, 20(4), 117–127. https://doi.org/10.1177/27536386231171813
Community Paramedicine through Multiple Stakeholder Lenses Using a Modified Soft Systems Methodology—Angela C Martin, Peter O’Meara, 2020. (n.d.). Retrieved October 25, 2024, from https://journals.sagepub.com/doi/abs/10.33151/ajp.17.793
Cooper, J. N., Lawrence, A. E., Koppera, S., Sebastian, S., Fischer, J. A., Minneci, P. C., & Deans, K. J. (2021). Effect of drug disposal bag provision on families’ disposal of children’s unused opioids. Journal of the American Pharmacists Association : JAPhA, 61(1), 109-114.e2. https://doi.org/10.1016/j.japh.2020.10.002
Descriptive before-and-after study of the introduction of a ‘Leave Behind’ take-home naloxone dispensing/distribution program by the ambulance service in Western Australia. (n.d.). Retrieved October 25, 2024, from https://journals.sagepub.com/doi/epub/10.1177/27536386231222283
Duvivier, H., Gustafson, S., Greutman, M., Jangchup, T., Harden, A. K., Reinhard, A., & Warshany, K. (2017). Indian Health Service pharmacists engaged in opioid safety initiatives and expanding access to naloxone. Journal of the American Pharmacists Association, 57(2), S135–S140. https://doi.org/10.1016/j.japh.2017.01.005
Essentia Health -. (n.d.). Retrieved October 25, 2024, from https://one-program.org/health-professionals/essentia-health/
Eukel, H., Steig, J., Hodges, A., O’Gary, B., & Strand, M. A. (2023). Nurse delivered medication safety screening program for home care visits. Public Health Nursing (Boston, Mass.), 40(3), 410–416. https://doi.org/10.1111/phn.13178
Eukel, H., Steig, J., Frenzel, O., Skoy, E., Werremeyer, A., & Strand, M. (2020). Opioid Misuse and Overdose: Changes in Pharmacist Practices and Outcomes. Journal of Continuing Education in the Health Professions, 40(4), 242–247. https://doi.org/10.1097/CEH.0000000000000317
Gummin, D. D., Mowry, J. B., Beuhler, M. C., Spyker, D. A., Rivers, L. J., Feldman, R., Brown, K., Pham, N. P. T., Bronstein, A. C., & DesLauriers, C. (2023). 2022 Annual Report of the National Poison Data System® (NPDS) from America’s Poison Centers®: 40th Annual Report. Clinical Toxicology, 61(10), 717–939. https://doi.org/10.1080/15563650.2023.2268981
Hales, C. M., Martin, C. B., & Gu, Q. (2020). Prevalence of Prescription Pain Medication Use Among Adults: United States, 2015-2018. NCHS Data Brief, 369, 1–8.
Harris, P. A., Taylor, R., Thielke, R., Payne, J., Gonzalez, N., & Conde, J. G. (2009). Research electronic data capture (REDCap)—A metadata-driven methodology and workflow process for providing translational research informatics support. Journal of Biomedical Informatics, 42(2), 377–381. https://doi.org/10.1016/j.jbi.2008.08.010
Integrating a Community Paramedicine Program with Local Health, Aged Care and Social Services: An Observational Ethnographic Study—Peter O’Meara, Michel Ruest, Angela Martin, 2015. (n.d.). Retrieved October 25, 2024, from https://journals.sagepub.com/doi/10.33151/ajp.12.5.238?icid=int.sj-abstract.citing-articles.185
Martin, A. C., & O’Meara, P. (2019). Perspectives from the frontline of two North American community paramedicine programs: An observational, ethnographic study. Rural and Remote Health, 19(1), 4888. https://doi.org/10.22605/RRH4888
Pharmacist Involvement in a Community Paramedicine Team—Baely M. Crockett, Karalea D. Jasiak, Todd A. Walroth, Kerri E. Degenkolb, Andrew C. Stevens, Carolyn M. Jung, 2017. (n.d.). Retrieved October 25, 2024, from https://journals.sagepub.com/doi/abs/10.1177/0897190016631893?casa_token=s5IKSpe4IuMAAAAA%3A5liqJRUcFaNWWjKXDUb27BzP-A-FwgWb4M1AzbGR4uHekWao7KGQHZddt8ePNmzVKZGqkOmMVUDb6w&journalCode=jppa
Picture of America: Poisonings. (n.d.). Retrieved October 25, 2024, from https://stacks.cdc.gov/view/cdc/142636
Shannon, B., Baldry, S., O’Meara, P., Foster, N., Martin, A., Cook, M., Stewart, K., & Miles, A. (2023). The definition of a community paramedic: An international consensus. Paramedicine, 20(1), 4–22. https://doi.org/10.1177/27536386221148993
Shannon, B., Eaton, G., Lanos, C., Leyenaar, M., Nolan, M., Bowles, K., Williams, B., O’Meara, P., Wingrove, G., Heffern, J., & Batt, A. (2022). The development of community paramedicine; a restricted review. Health & Social Care in the Community, 30(6), e3547–e3561. https://doi.org/10.1111/hsc.13985
Skoy, E., Eukel, H., Werremeyer, A., Strand, M., Frenzel, O., & Steig, J. (2020). Implementation of a statewide program within community pharmacies to prevent opioid misuse and accidental overdose. Journal of the American Pharmacists Association: JAPhA, 60(1), Article 1. https://doi.org/10.1016/j.japh.2019.09.003
Skoy, E., Werremeyer, A., Steig, J., Eukel, H., Frenzel, O., & Strand, M. (2021). Patient acceptance of naloxone resulting from targeted intervention from community pharmacists to prevent opioid misuse and accidental overdose. Substance Abuse, 42(4), Article 4. https://doi.org/10.1080/08897077.2020.1827126
SQUIRE | SQUIRE 2.0 Guidelines. (n.d.). Retrieved October 26, 2024, from https://www.squire-statement.org/index.cfm?fuseaction=Page.ViewPage&PageID=471
Strand, M. A., Eukel, H. N., Frenzel, O., Skoy, E., Steig, J., & Werremeyer, A. (2022). Opioid risk stratification in the community pharmacy: The utility of the Opioid Risk Tool. Research in Social & Administrative Pharmacy: RSAP, 18(12), Article 12. https://doi.org/10.1016/j.sapharm.2022.07.009
Stroupe, K. T., Murray, M. D., Stump, T. E., & Callahan, C. M. (2000). Association between medication supplies and healthcare costs in older adults from an urban healthcare system. Journal of the American Geriatrics Society, 48(7), 760–768. https://doi.org/10.1111/j.1532-5415.2000.tb04750.x
The advantages and challenges experienced with the implementation and delivery of community paramedicine programmes: A qualitative reflexive thematic analysis—Brendan Shannon, Alan M. Batt, Georgette Eaton, Matthew Leyenaar, Peter O’Meara, Tomas Barry, Chelsea Lanos, Gary Wingrove, Brett Williams, Michael Nolan, Ray Carney, J.D Heffern, Kelly-Ann Bowles, 2023. (n.d.). Retrieved October 25, 2024, from https://journals.sagepub.com/doi/full/10.1177/27536386231188595
Thorpe, C. T., Bryson, C. L., Maciejewski, M. L., & Bosworth, H. B. (2009). Medication acquisition and self-reported adherence in veterans with hypertension. Medical Care, 47(4), 474–481. https://doi.org/10.1097/mlr.0b013e31818e7d4d
webPOISONCONTROL Data Analysis Dashboard. (n.d.). Retrieved April 5, 2024, from https://www.poison.org/webpoisoncontrol-data-analysis-dashboard
Webster, L. R., & Webster, R. M. (2005). Predicting aberrant behaviors in opioid-treated patients: Preliminary validation of the Opioid Risk Tool. Pain Medicine (Malden, Mass.), 6(6), 432–442. https://doi.org/10.1111/j.1526-4637.2005.00072.x
Werremeyer, A., Frenzel, O., Strand, M. A., Eukel, H., Skoy, E., & Steig, J. (2022). Improving Community Pharmacist-Delivered Care for Patients With Psychiatric Disorders Filling an Opioid Prescription. Psychiatric Services (Washington, D.C.), 73(11), Article 11. https://doi.org/10.1176/appi.ps.202100592
Werremeyer, A., Strand, M. A., Eukel, H., Skoy, E., Steig, J., & Frenzel, O. (2022). Longitudinal evaluation of pharmacists’ social distance preference and attitudes toward patients with opioid misuse following an educational training program. Substance Abuse, 43(1), Article 1. https://doi.org/10.1080/08897077.2022.2060449