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Development and Initial Testing of A Pilot Pharmacy-Based Digital Opioid Safety Intervention

Funding Source

National Institute on Drug Abuse – Center for Technology and Behavioral Health Pilot Core

Project Period

February 2023 - February 2024

Principal Investigator

Deepika Rao, PhD

Other Project Staff

Sarah Lord, PhD (mentor); Lisa A Marsch, PhD (mentor)

Project Summary

There was a 16% increase in prescription-opioid involved death rates in 2020, despite the declining trend in opioid prescribing rates observed since 2012. While stricter opioid prescribing guidelines have not sufficiently addressed opioid safety concerns, they have also led to opioid access issues especially among racial and ethnic minority populations. Prevention interventions such as screening education, prescription monitoring programs, and naloxone dispensing can reduce opioid misuse and promote opioid safety, while ensuring appropriate medication access. Community pharmacists are uniquely positioned to offer opioid misuse prevention interventions due to their high accessibility and medication expertise.

However, our initial research identified pharmacist reported implementation barriers including mixed perceptions for the need for change in pharmacy practice and perceived inability to change setting characteristics or workflows significantly to accommodate prevention interventions. Patient-identified needs regarding prevention interventions included opioid and safety education, privacy and convenience through digital rather than in-person formats, messaging in non-stigmatizing language, and improved communication with their healthcare teams. Among the various prevention interventions identified in our prior study, patients prioritized patient-centered opioid safety education while pharmacists highlighted the need for improved naloxone dispensing. Patient-centered digital educational interventions that promote pharmacist roles in opioid misuse prevention are lacking. Thus, there is a critical need to develop a digital opioid safety educational intervention that meets patient needs and promotes pharmacist dispensing of naloxone.

Overall, our objective of this pilot proposal is to develop a prototype of an opioid safety educational tool and evaluate its feasibility and acceptability among pharmacists and patients. Upon successful completion of this project, we will have a first-version prototype and storyboards of the opioid safety prototype educational tool that depicts program look-and-feel, includes program content and delivery approaches, and demonstrates program navigation and flow. We will also collect preliminary usability, feasibility, and acceptability data on this prototype from representative end-user patients and pharmacists. Findings from our pilot project will inform future research on pharmacist roles in prevention of opioid misuse, especially using digital health technologies.