Prescription opioid use: Patient characteristics and misuse in community pharmacy

Abstract

ObjectivesOpioid pain medication misuse is a major concern for US public health. The purpose of this article is to: 1) describe the demographic and physical, behavioral, and mental health characteristics of patients who fill opioid medications in community pharmacy settings; and 2) describe the extent of opioid medication misuse behaviors among these patients. DesignWe recruited and screened a convenience sample of patients with the use of a tablet computer–based assessment protocol that examined behavioral, mental, and physical health. Descriptive and inferential statistics were calculated to describe respondents and their opioid medication misuse and health characteristics. SettingPatients were screened in 2 urban and 2 rural community pharmacies in southwestern Pennsylvania. ParticipantsSurvey participants were adult patients filling opioid pain medications who were not currently receiving treatment for a cancer diagnosis. InterventionNone. Main outcome measuresValidated screening measures included the Prescription Opioid Misuse Index, Alcohol Use Disorders Identification Test C, Short Form 12, Drug Abuse Screening Test 10, Primary Care Post-traumatic Stress Disorder (PTSD) screen, and the Patient Health Questionnaire 2. ResultsA total of 333 patients were screened (71.2% response rate). Nearly the entire population reported pain above and general health below national norms. Hydrocodone (19.2%) and morphine (20.8%) were found to be the medications with the highest rates of misuse—with hydrocodone having more than 4 times higher odds of misuse compared with other medications (adjusted odds ratio [AOR] 4.48, 95% confidence interval [CI] 1.1–17.4). Patients with positive screens for illicit drug use (AOR 8.07, 95% CI 2.7–24.0), PTSD (AOR 5.88, 95% CI 2.3–14.7), and depression (AOR 2.44, 95% CI 1.0–5.9) also had significantly higher odds for misuse compared with those with negative screening results. ConclusionThese findings provide important foundational data that suggest implementation of regular opioid misuse screening protocols within community pharmacies. Such screening activities could foster a culture of prevention and overall reduction for misuse among patients filling opioid medications in community pharmacies.