AN EVALUATION OF SAFER OPIOID PRESCRIBING:
THE AESOP STUDY
Prescription opioid misuse and dependence has become an increasing problem and is linked to an array of negative consequences including addiction, overdose, and mortality. Although most chronic opioids are prescribed in the community, use in hospital and on discharge significantly increases the risk of chronic use and is often the first point of use for previously opioid naïve patients. While the use of high dose opioids in hospital can increase the risk of adverse events and length of stay, untreated pain continues to remain an issue for many patients, and finding the balance of managing pain while using opioids as safely as possible remains an ongoing struggle.
The Opioid Stewardship Program at St. Paul’s Hospital is a systems-level intervention developed to address this ongoing gap in care. Implemented in January 2020, the opioid stewardship clinical team consists of a clinical pharmacy specialist and addiction medicine physician who review and assess patients throughout the hospital and provide recommendations to improve the use of opioids. The program also addresses system wide prescribing through education and review of hospital policies and order sets.
- St. Paul's Hospital Opioid Stewardship Program: 6 Month Program Report - January to June 2020.
- Kim, B., Nolan, S., Beaulieu, T., Shalansky, S.,Ti, L. Inappropriate opioid prescribing practices: A narrative review. American Journal of Health-System Pharmacy. 2019;76(16), 1231-1237.
- Ti, L., Nolan, S. Managing Acute Pain in the Hospital in the Face of the Opioid Crisis. Annals of Internal Medicine. 2019;170(9), 665-666.
- Parmar G, Ti L, Nolan S. Opioid prescribing in-hospital: time for innovative approaches to help combat the opioid crisis. Canadian Journal of Addiction. 2019;10(2), 44-47.
- Kim, B., Nolan, S.,Ti, L.(2017). Inappropriate opioid prescribing in hospitals: Time for an innovative solution. Drug and Alcohol Review. 2019;36, 149-152.