Role of pharmacists in optimising opioid therapy for chronic non-malignant pain; A systematic review

Iqbal, Ayesha; Knaggs, Roger David; Anderson, Claire; Toh, Li Shean

Abstract

Background: Opioid optimisation is a global issue in Chronic Non-malignant Pain (CNMP) management. Objective: This systematic review aims to assess the effectiveness of interventions delivered by pharmacists in outpatient clinical settings, community pharmacies and primary care services in optimising opioid therapy for people with CNMP and to explore stakeholders’ opinions about role of pharmacists in optimising opioid therapy. Methods: We conducted searches in PubMed, CINAHL, Psych Info, EMBASE, ISI Web of Science and Conference Proceedings and International Pharmaceutical Abstracts. All studies where pharmacists in outpatient clinical settings, community pharmacies and patient care services helped in optimisation of opioids in the treatment of CNMP as individuals or part of a team were included. Authors followed the 27-item PRISMA guidelines and the review was registered in PROSPERO. All authors were involved in screening and selection of studies and included studies between January 1990–June 2020. Studies not published in English language and participants with cancer pain were excluded. All the included studies were descriptively synthesized. Results: Fourteen studies were included in the final data synthesis of this review and the total number of participants in all studies was 1175. Interventions by pharmacists were successful in decreasing opioid dose in 4 studies and improved patient opioid safety in 5 studies. Stakeholders considered that the role of pharmacists in optimisation of opioid therapy for people with CNMP can be promising and should be further developed. Conclusion: This systematic review gives an overview of pharmacist intervention feasibility, stakeholders’ opinions and possible benefits on opioid optimisation in people with CNMP in outpatient clinical settings, community pharmacies and primary care settings. However, further research is warranted, which can guide the development of new policies and guidelines for the utilisation of pharmacists to promote opioid safety in people using prescription opioids for CNMP management.

Citation

Iqbal, A., Knaggs, R. D., Anderson, C., & Toh, L. S. (2022). Role of pharmacists in optimising opioid therapy for chronic non-malignant pain; A systematic review. Research in Social and Administrative Pharmacy, 18(3), 2352-2366. https://doi.org/10.1016/j.sapharm.2020.11.014

• Journal Article Type: Review
• Acceptance Date: Nov 23, 2020
• Online Publication Date: Nov 24, 2020
• Publication Date: 2022-03
• Deposit Date: Dec 15, 2020
• Publicly Available Date: Nov 25, 2021
• Journal: Research in Social and Administrative Pharmacy
• Print ISSN: 1551-7411
• Electronic ISSN: 1934-8150
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 18
• Issue: 3
• Pages: 2352-2366
• DOI: https://doi.org/10.1016/j.sapharm.2020.11.014
• Keywords: Pharmaceutical Science; Pharmacy
• Public URL: https://nottingham-repository.worktribe.com/output/5069151
• Publisher URL: https://www.sciencedirect.com/science/article/abs/pii/S1551741120311992