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2023-06-12
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Pharmacy Practice & Practice-Based Research
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Copyright (c) 2023 Insaf Mohammad, Sarah Alsomairy, Mona Mawari, Mohamad Elabdallah, Ruaa Elteriefi, Julie George
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Copyright of content published in INNOVATIONS in pharmacy belongs to the author(s).
Evaluation of Interprofessional Quality Improvement Interventions Led by an Ambulatory Care Pharmacist on Adherence to a Controlled Substance Agreement Policy
Insaf Mohammad
Wayne State University Eugene Applebaum College of Pharmacy and Health Sciences
Sarah Alsomairy
Department of Pharmacy, Corewell Health - Dearborn Hospital
Mona Mawari
Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University
Mohamad Elabdallah
Department of Internal Medicine, Corewell Health - Dearborn Hospital
Ruaa Elteriefi
Department of Internal Medicine, Corewell Health - Dearborn Hospital
Julie George
Beaumont Research Institute, Corewell Health
DOI: https://doi.org/10.24926/iip.v14i2.5464
Keywords: interprofessional, ambulatory care, pharmacist, controlled substance, opioid
Abstract
Background: A controlled substance agreement (CSA) is a risk mitigation strategy for patients managed on controlled substance medications such as opioids and benzodiazepines. Limited literature exists to describe the role of the clinic pharmacy team to promote adherence to CSA monitoring parameters.
Objective: The objective of this study is to evaluate the impact of interprofessional educational and clinical interventions led by an ambulatory care pharmacist on adherence to monitoring parameters within a CSA policy.
Methods: This retrospective observational study included patients on long-term controlled substances who had a clinic visit every 3 months during the study period. The primary outcomes were the proportion of patients with a signed CSA in the electronic medical record (EMR), urine drug screen (UDS) completion, and documentation of review of the statewide prescription drug monitoring program (PDMP) in the EMR 8 months prior to as compared to 8 months after implementation of pharmacist interventions.
Results: Among 79 patients (mean age 55.7 years, 65.8% female, 54.4% African American), 8.9% pre- vs 88.6% post-interventions had a signed CSA (p<0.001), 35.4% pre- vs 65.8% post-interventions had a UDS completed (p<0.001), and 32.9% pre- vs 57% post-interventions had documentation of PDMP review (p=0.002).
Conclusion: Adherence to monitoring parameters within a CSA policy significantly improved after educational and clinical interventions led by an ambulatory care pharmacist.
