Category: Fellows Posters
Purpose: Opioid misuse is a public health crisis in the United States (US). Strategies to fight the epidemic do not directly address patient education on opioid medications’ effects and risks when prescribed. Though there are examples in the literature on the impact of opioid-related education on healthcare providers’ prescribing practices, little exists about the impact of patient education on opioids and the outcomes of the education. The purpose of this systematic review was to describe educational interventions focusing on patients who were prescribed opioid medications and the outcomes of these interventions.
Methods: The search used Boolean terms, combining the concepts of opioids, patient education, and healthcare practitioner. Each concept included thesaurus terms, like MeSH (when available), and free text terms (title, abstract, and keyword). Five databases (PubMed, IPA, CINAHL, Academic Search Premier, and Health Source: Nursing/Academic Edition) were searched. English language and date filters were used in all databases. The original search was conducted October 5, 2017, and updated on October 22, 2018. A validated de-duplication process resulted in a final set of 4,394 citations. Titles and abstracts were evaluated independently by two investigators to determine inclusion in the review. Inclusion criteria were English-language peer-reviewed articles whose studies took place between 1996 to present day in the US and whose studies examined provider-led patient education given to adults 18 years of age or older. Exclusion criteria were unavailable or duplicate articles; studies that did not explore healthcare provider-initiated educational interventions targeting opioid medications; and studies taking place outside of the US. Discrepancies were resolved by the two investigators. Unresolved discrepancies were reviewed by a third investigator to determine whether they met inclusion criteria.
Results: The titles and abstracts of 4863 manuscripts were screened for inclusion in this review. Of these, 4794 were removed because they did not meet inclusion criteria, primarily due to not evaluating a patient-focused educational intervention; not being a peer-reviewed study; and taking place outside the US. The full texts of the remaining 69 documents were evaluated for inclusion. Ten articles were identified for inclusion in this review. The included studies explored the impact of prescription opioid-related education on mortality (n=1), adherence (n=4), self-efficacy or self-care (n=1), quality of life (n=2), or knowledge (n=2). Included studies may have had multiple outcomes. A variety of educational methods was used, including face-to-face follow-up (most commonly used), multimedia use, pre-discharge counseling, and written information complementing verbal information.
Conclusion: There are several well-documented interventions identifying methods to manage opioid use disorder, but little exists about providing education to patients before they receive opioid prescriptions. Future research should explore what type of education and information is being shared with patients, as this could inform pharmacists and student pharmacists in how they should counsel their patients appropriately.