Impact of a Pharmaceutical Interview at the Initiation of Opioid Treatment for Acute Non-cancer Pain

Impact of a Pharmaceutical Interview on the Initiation of Opioid Treatment for Acute Non-cancer Pain in Short Stay Hospitalization Units (UHCD) and Downstream Hospitalization Units (UHA) of Adult Emergency Departments

In adult emergency departments, the number of admissions for adverse effects related to opioid use is constantly increasing. However, the massive flow of patients, lack of time, and rapid rotation of physicians in this department do not favor the transmission of in-depth information on the proper use of these therapies to the patient. In addition, this therapeutic class tends to worry patients. Public authorities as well as the medical profession are concerned about the potential adverse effects of morphine, but also the potential misuse, or even overdose, which can be fatal for the patient. Interventions by the community pharmacist in the fight against this misuse seem interesting, but an intervention upstream of potential problems of proper use seems even more relevant to us. Recent studies have shown the strong interest of the pharmacist in a multidisciplinary team on pain and opioids, both at the local level with studies conducted at the Rouen University Hospital by C. LATTARD et al. in rheumatology and E.BARAT et al. in outpatient surgery. It also appears that knowledge on the subject is satisfactory. Work conducted by Winstanley et al. shows that the intervention of a pharmacist in the emergency department seems relevant in terms of patient knowledge and satisfaction, and entirely feasible.

This study aims to measure the clinical impact of a hospital pharmacist when initiating opioid treatment for acute non-cancer pain in the Short Stay Hospitalization Units (UHCD) and Downstream Hospitalization Units (UHA) of the adult emergency department at Rouen University Hospital.

Pharmacy interviews will be offered to patients meeting the inclusion criteria. These 15- to 30-minute interviews will aim to present the tools implemented by the Rouen University Hospital pharmacy team. Several topics will be discussed, including: treatment optimization, potential adverse effects and what to do if they occur, the differences between immediate-release (IR) and extended-release (LP) forms, what to do if a dose is missed, the risks of overdose and addiction, and storage methods.

The objective of this project is, firstly, to improve patient satisfaction with their care and, secondly, to better understand the treatment, thus enabling more optimal use.

Inclusion Criteria:

• Adult patient (>18 years old)
• Patient admitted to the following departments: Downstream Hospitalization Unit (UHA) and Short-Term Hospitalization Unit (UHCD)
• Independent patient or assisted by close family (who can receive information with the patient)
• Initiation of opioid treatment for acute non-cancer pain during their stay in the Emergency Department, UHA, or UHCD or shortly before (<7 days)
• Patient speaks French
• Presence of the clinical pharmacist in the relevant departments

Exclusion Criteria:

• Patient with drug addiction
• Patient under guardianship/guardianship
• Patient transferred to rheumatology
• Patient already on opioid treatment for ≥ 7 days
• Patient refuses
• Patient assisted by a nurse at home or a caregiver not present during hospitalization