Abstract
Background: Overdose education and naloxone training was recently implemented into the required curriculum of the College of Pharmacy at the University of Rhode Island. The objective of this study was to compare the retention of knowledge between student pharmacists who received a didactic lecture only versus student pharmacists who received the same lecture plus a skills-based objective structured clinical examination (OSCE) with a standardized patient actor.Methods: Students in their first-professional year (P1) of the Doctor of Pharmacy program (n = 129) and students in their second-professional (P2) year (n = 123) attended a required lecture on opioid overdose, including detailed naloxone training. P2 students were additionally required to participate in an OSCE assessment following the didactic lecture component. An anonymous, voluntary survey was offered to all students approximately 6 months later. A Chi-Square or Fisher's Exact Test was performed on the survey responses to assess any difference in the responses between the two groups.Results: A total of 99 P1 students (76.7%) and 116 P2 students (94.3%) completed the survey. P1 students were found to be more knowledgeable regarding the duration of naloxone action and identification of risk factors for opioid overdose. P2 students were found to be more knowledgeable regarding non-medical ways patients may obtain opioids and the correct order of emergency response during a suspected opioid overdose…Conclusions: P2 students did not demonstrate superior retention of information regarding naloxone and opioid use disorder on survey questions compared with P1 students. There was a trend towards P2 students feeling more confident in their ability to counsel patients for overdose prevention and reporting disagreement with the statement that “overdose prevention for people who use drugs is a waste of time and money” compared with the P1 students, but these did not reach statistical significance. Since the opioid crisis continues unabated, naloxone training using OSCE and didactic methods remain an on-going required part of the pharmacy curriculum.
Highlights
The World Health Organization estimates that 69,000 people die each year due to drug overdose, with over 47,000 of these deaths in the United States alone.[1]
Of the 252 students that received the didactic lecture covering naloxone administration and opioid overdose, a total of 215 (85.3%) students participated in the survey
While there was a trend towards P2 students reporting increased confidence versus P1 students when asked to counsel patients on overdose prevention and disagreeing with the statement “overdose prevention for people who use drugs is a waste of time and money”, these did not reach statistical significance
Summary
The World Health Organization estimates that 69,000 people die each year due to drug overdose, with over 47,000 of these deaths in the United States alone.[1]. People at risk to experience an overdose are those who administer substances through nonmedical routes (i.e. injection or insufflation), utilize high doses of opioids, are co-prescribed benzodiazepines, are co-prescribed antidepressants or sedatives/hypnotics, utilize long-acting opioid formulations, use more potent opioid drugs (such as fentanyl), obtain opioid prescriptions from multiple providers and pharmacies, or have a history of mental illness, alcohol or substance abuse disorder.[3,4,5,6,7,8,9,10] Opioid-related overdose risk is highest in those with decreased tolerance who relapse into use following a period of abstinence, such as time spent in detoxification programs or incarceration, when quantities of drug used previously are reintroduced.[11,12] Patients receiving 100 or more morphine milligram equivalents (MME) per day, compared to patients with less than 100 MME, have been shown to have an 8.9-fold increase in risk of opioid overdose.[10] Many overdoses occur in the presence of one or more bystanders and with proper training and tools, especially the opioid-reversal agent naloxone, these individuals could potentially save lives by stopping an overdose from progressing.[13]. The objective of this study was to compare the retention of knowledge between student pharmacists who received a didactic lecture only versus student pharmacists who received the same lecture plus a skills-based objective structured clinical examination (OSCE) with a standardized patient actor
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