Introduction
The opioid epidemic has been a significant public health crisis, with over 500,000 opioid overdose deaths in the United States between 1997 and 2020. Retail pharmacies have played a crucial role in this crisis, yet their practices remain under-researched. A recent study titled "Retail chain pharmacy opioid dispensing practices from 1997 to 2020: A content analysis of internal industry documents" sheds light on the contribution of pharmacies to the opioid epidemic through improper opioid prescription dispensing. This blog explores key findings from this study and offers insights for practitioners to improve their dispensing practices.
Key Findings
The study identified four primary factors contributing to improper opioid dispensing practices:
- Store-Level Procedures: Inconsistent procedures across stores led to unresolved red flags in opioid prescriptions. This included dispensing opioids without proper investigation and filling prescriptions with missing prescriber DEA numbers.
- Management Pressure: Pharmacists faced pressure from management to fill more opioid prescriptions, often prioritizing sales over patient safety. This pressure was linked to bonus structures and metrics that incentivized higher prescription volumes.
- Distribution Center Activities: Distribution centers failed to monitor and report suspicious orders adequately. High volumes of opioids were shipped to certain stores, contributing to improper dispensing.
- Pharmaceutical Company Sponsorship: Pharmaceutical companies, such as Purdue, sponsored continuing education programs that encouraged pharmacists to dispense higher dosages of opioids.
Implications for Practitioners
Practitioners can use the insights from this study to enhance their dispensing practices and improve patient safety. Here are some actionable steps:
- Implement Rigorous Verification Processes: Establish consistent procedures for verifying opioid prescriptions, including checking for prescriber DEA numbers and investigating red flags.
- Advocate for Policy Changes: Encourage policies that exclude addictive medications from store metrics and bonus structures to prevent perverse incentives.
- Enhance Pharmacist Autonomy: Support legal protections for pharmacists to use their clinical judgment without undue influence from management.
- Promote Independent Continuing Education: Advocate for continuing education programs that are independent of pharmaceutical company sponsorship to avoid conflicts of interest.
Conclusion
The findings from this study provide valuable insights into the factors contributing to improper opioid dispensing practices in retail pharmacies. By implementing the suggested practices, practitioners can help reduce the risk of opioid misuse and improve patient outcomes. For those interested in exploring this topic further, the original research paper offers a comprehensive analysis of these issues.
To read the original research paper, please follow this link: Retail chain pharmacy opioid dispensing practices from 1997 to 2020: A content analysis of internal industry documents.
