SHPA provides feedback to ACSQHC on a National Opioid Analgesic Stewardship Program

SHPA has provided feedback to the Australian Commission on Safety and Quality in Health Care on the National Opioid Analgesic Stewardship Program consultation and congratulated the Commission on establishing this program of work, which addresses key recommendations made in SHPA’s Reducing opioid-related harm: A hospital pharmacy landscape paper.

SHPA consulted with Specialty Practice's Emergency MedicineSurgery and Perioperative Medicine, Education and Educational Visiting, Medication Safety, and Pain Management Leadership Committees to develop a range of recommendations. All recommendations linked to a fundamental change of culture in hospitals and a prioritisation of Opioid Analgesic Stewardship.

We highlighted the need for a re-orientation of hospital governance towards the importance of the work of Opioid Analgesic Stewardship Pharmacists and clinical pharmacists in the emergency, and perioperative and surgical settings, to ensure safe and optimal use of opioid analgesics for all Australians in the acute care setting.

We also emphasised the need for a holistic approach to reduce opioid-related harm as highlighted in the discussion paper, and address the ways in which topics listed for discussion (emergency department, perioperative and surgical services, and prescriber education and training), are interlinked.

SHPA's recommendations

Topic 1: Emergency Department

  1. Pharmacist-led Opioid Analgesic Stewardship initiatives should be embedded in all hospital emergency departments, to support the safe and appropriate use of opioid analgesics.
  2. All emergency departments should have dedicated clinical pharmacy services, to support the safe and responsible prescribing of opioid analgesics.

Topic 2: Perioperative and surgical services

  1. Pharmacist-led Opioid Analgesic Stewardship initiatives should be embedded in all hospital perioperative and surgical services, to support the safe and appropriate use of opioid analgesics.
  2. Multidisciplinary acute pain outreach services including Opioid Analgesic Stewardship Pharmacists should be established to provide follow up to patients discharged from hospital post-surgery with opioid analgesics.
  3. All perioperative and surgical services should have dedicated clinical pharmacy services, to support the safe and effective use of opioids, including medication reconciliation, clinical review of patients and risk factors, and a review of post-surgery opioid analgesic use.
  4. All prescriptions of opioid analgesics in the post-surgical setting should be accompanied by an opioid de-escalation or cessation management plan for the patient, carer and primary care provider.

Topic 3: Prescriber education and training

  1. Opioid Analgesic Stewardship Pharmacists should be involved in the provision of review and feedback to prescribers on an individual and small group level, to influencing prescribing behaviour in units with high opioid analgesic usage.
  2. Opioid Analgesic Stewardship Pharmacists should lead and contribute to the development, promotion, implementation and maintenance of best practice opioid analgesic prescribing guidelines, procedures and protocols concerning the optimal use of opioids and analgesia.
  3. National implementation of electronic medication management (EMM) systems across all Australian hospitals to support the gathering and collation of nationally standardised data sets for organisations to benchmark against and to aid in timely extraction of prescribing data to be used in educating and training of prescribers.

See the full submission →