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Jadhari R, Pathak N, Shrestha R, Shrestha S, KC B, Gan SH, Paudyal V. Advancing opioid stewardship in low-middle-income countries: challenges and opportunities. J Pharm Policy Pract 2024; 17:2345219. [PMID: 38845626 PMCID: PMC11155429 DOI: 10.1080/20523211.2024.2345219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2024] Open
Abstract
The increased utilization of opioids in low- and middle-income countries (LMICs) presents a growing threat of opioid-related abuse, misuse and diversion. Pharmacists, as integral members of healthcare teams, are responsible for dispensing and monitoring opioid use and hold a pivotal role in opioid stewardship within LMICs. This commentary describes the potential and multifaceted roles of pharmacists in opioid stewardship in resource-constrained settings and highlights appropriate strategies for promoting responsible opioid utilization. Opioid stewardship involves prioritising evidence-based prescribing, management and practices for pain management. It includes measures such as incorporating prescription drug monitoring programmes for appropriate opioid prescription, implementing safe disposal through drug take-back programmes, promoting non-opioid pain management, addressing the opioid addiction stigma, tapering opioid dose, educating patients and caregivers, establishing drug information centers, providing rehabilitative services and integrating collaboration with communities and experts. The combined difficulties of restricted access to healthcare resources and services coupled with low levels of literacy worsen the susceptibility to opioid abuse, misuse, and diversion in LMICs. Early detection, assessment and implementation of interventions to optimise opioid use are imperative for ensuring safe and effective opioid utilization, thereby mitigating the risks of overdose and addiction. The involvement of pharmacists in promoting safe and effective opioid utilization through education, monitoring, collaboration, and policy advocacy serves as a critical component in bridging existing gaps in opioid stewardship within LMICs.
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Affiliation(s)
- Rojita Jadhari
- Drug Discovery and Development, Faculty of Pharmacy, Uppsala University, Uppsala, Sweden
| | - Nabin Pathak
- Drug Information Unit and Pharmacovigilance Cell, Department of Pharmacy, Hetauda Hospital, Madan Bhandari Academy of Health Sciences, Bagmati Province, Makwanpur, Hetauda, Nepal
- Department of Pharmacy and Clinical Pharmacology, Madan Bhandari Academy of Health Sciences, Bagmati Province, Makwanpur, Hetauda, Nepal
| | - Rajeev Shrestha
- Palliative Care and Chronic Disease, INF Nepal Green Pastures Hospital and Rehabilitation Centre, Pokhara, Nepal
| | - Sunil Shrestha
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Bhuvan KC
- School of Clinical Sciences, Queensland University of Technology, Brisbane, Australia
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
| | - Siew Hua Gan
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Vibhu Paudyal
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, United Kingdom
- School of Pharmacy, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
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Khazen M, Kamin-Friedman S. Overlooking the obvious: the importance of communicating safety and risks of opioids-the Israeli context. Front Pharmacol 2024; 15:1356968. [PMID: 38855742 PMCID: PMC11157061 DOI: 10.3389/fphar.2024.1356968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Accepted: 04/29/2024] [Indexed: 06/11/2024] Open
Affiliation(s)
- Maram Khazen
- Max Stern Academic College of Emek Yezreel, Emek Yezreel, Israel
| | - Shelly Kamin-Friedman
- Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Department of Bioethics, The School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
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Tafere C, Tefera BB, Yehualaw A, Demsie DG, Kefale B, Feyisa K, Yismaw MB, Aschale E, Debasu Z, Yilma Z, Agmassie Z, Siraj IA, Yayehrad AT, Mulatu S, Endeshaw D. Community Pharmacists' Knowledge and Attitude Towards Opioid Pain Medication Use in Bahir Dar City, North-West Ethiopia. J Multidiscip Healthc 2024; 17:833-841. [PMID: 38434484 PMCID: PMC10908331 DOI: 10.2147/jmdh.s452350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 02/21/2024] [Indexed: 03/05/2024] Open
Abstract
Background Opioid use is a major global public health problem, affecting 16 million individuals worldwide. According to a 2023 WHO report, out of the 600,000 substance-related deaths worldwide, 80% were attributed to opioid use. Pharmacists play a vital role in reducing unnecessary opioid exposure while facilitating access to non-opioid alternatives. To do so, pharmacists should have sufficient knowledge regarding opioid-containing medications and a positive attitude about opioid use problems. Objective This study aimed to evaluate community pharmacists' knowledge of opioid-containing medications and their attitude toward opioid use problems. Materials and methods A cross-sectional study was conducted using a self-administered, structured questionnaire distributed to 105 community pharmacists from July 1-30, 2023 in Bahir Dar City, Ethiopia. The tool included demographic information and questions designed to assess participants' knowledge and attitudes. Results Out of the 105 pharmacists included in this study, majority were males (54.3%), nearly half held a bachelor's degree (49.5%), and slightly above one-third had over a decade experience (39%). Regarding knowledge and attitude towards opioids, 62 individuals (59%) exhibited good knowledge, and 64 (61%) demonstrated less stigma toward opioid usage. Factors affecting knowledge include: education level (AOR (95% CI): 8.43 (1.76-40.35) and 9.93 (1.04-85.33) for bachelors and postgraduates respectively and age 1.45 (1.20-1.77)]. Meanwhile, experience [AOR (95% CI): 4.64(1.20-17.90) and 4.29 (1.23-15.05)] for 5-9 years and ≥10 years respectively and education level [AOR (95% CI): 4.08 (1.40-11.93) for bachelors and 6.40 (1.42-28.96)] for postgraduates were linked to attitude. Conclusion A gap in knowledge and more stigmatizing behavior was observed among community pharmacists. These findings imply the importance of tailored educational interventions to address knowledge gaps and promote positive attitudes toward opioid usage among community pharmacists. Therefore, it is imperative to deliver up-to-date information on opioids, emphasizing their high addiction potential, to ensure pharmacists are well-equipped with the latest information.
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Affiliation(s)
- Chernet Tafere
- Department of Pharmaceutics, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Amhara, Ethiopia
| | - Bereket Bahiru Tefera
- Department of Social Pharmacy, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Amhara, Ethiopia
| | - Adane Yehualaw
- Department of Pharmaceutics, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Amhara, Ethiopia
| | - Desalegn Getnet Demsie
- Department of Pharmacology, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Amhara, Ethiopia
| | - Belayneh Kefale
- Department of Clinical Pharmacy, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Amhara, Ethiopia
| | - Kebede Feyisa
- Department of Pharmacognosy, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Amhara, Ethiopia
| | - Malede Berihun Yismaw
- Department of Clinical Pharmacy, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Amhara, Ethiopia
| | - Endalamaw Aschale
- Department of Clinical Pharmacy, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Amhara, Ethiopia
| | - Zenaw Debasu
- Department of Clinical Pharmacy, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Amhara, Ethiopia
| | - Zewdu Yilma
- Department of Pharmaceutics, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Amhara, Ethiopia
| | - Zegaye Agmassie
- Department of Clinical Pharmacy, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Amhara, Ethiopia
| | - Ibrahim Abdela Siraj
- Department of Pharmaceutics, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Amhara, Ethiopia
| | - Ashagrachew Tewabe Yayehrad
- Department of Pharmaceutics, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Amhara, Ethiopia
| | - Sileshi Mulatu
- Department of Pediatrics and Child Health Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Amhara, Ethiopia
| | - Destaw Endeshaw
- Department of Adult health Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Amhara, Ethiopia
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Kakatkar S, Narayan A, Balkrishnan R. Prescription analgesic overuse in older adults: Can we mitigate this growing problem? Aging Med (Milton) 2022; 5:294-296. [PMID: 36606265 PMCID: PMC9805287 DOI: 10.1002/agm2.12228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 10/17/2022] [Accepted: 10/18/2022] [Indexed: 11/16/2022] Open
Abstract
With older adults already on numerous prescription medications to manage their chronic conditions, the addition of pain medications could impose an even greater burden due to dependency issues. We need to understand the use of chronic pain medication, especially opioids, discuss current strategies and gaps, and offer potential solutions to mitigate overuse among older adults.
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Affiliation(s)
- Sara Kakatkar
- Department of Public Health SciencesUniversity of Virginia School of MedicineCharlottesvilleVirginiaUSA
| | - Aditya Narayan
- Department of Public Health SciencesUniversity of Virginia School of MedicineCharlottesvilleVirginiaUSA
| | - Rajesh Balkrishnan
- Department of Public Health SciencesUniversity of Virginia School of MedicineCharlottesvilleVirginiaUSA
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