News

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New patient guide aims to reduce opioid harms

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Many Australians leave hospital with more opioids than are needed to manage their pain, according to a survey conducted by the Society of Hospital Pharmacists Australia (SPHA).
 
Dr Milana Votrubec, Chair of the RACGP Specific Interests Pain Management network, told newsGP that this situation can in turn lead to patients putting pressure on GP once their initial supply has run out.
 
‘It’s been a bugbear, that patients are coming out [of hospital] with these drugs almost thinking they’re obliged to take them whether they need them or not: “It’s been given to me by the doctors in the hospital and I must have some”,’ she said.
 
But this practice, especially when provided without relevant information pertaining to opioid use, can lead to serious harm.
 
‘With statistics showing three lives are lost, 150 people are hospitalised and 14 people present to emergency departments every day due to harm caused by pharmaceutical opioids, we need to ensure more information is available to people at the point these medicines are prescribed,’ Associate Professor Steve Morris, Chief Executive of NPS MedicineWise, said.
 
To combat the problem, NPS MedicineWise’s Choosing Wisely initiative has released a two-page guide, ‘Managing pain and opioid medicines’, to be given to people prescribed opioids as inpatients or on discharge.
 
The guide aims to raise awareness about the use of opioids for short-term pain, their side effects and the risk of dependence, and features three key elements to support people who are prescribed opioids:

• Questions people can ask their health professional before leaving hospital with opioids, based on the Choosing Wisely ‘5 questions to ask your doctor’ model.
• Tips for taking and storing opioids at home, including to take leftover medicines to the pharmacy for safe disposal.
• A personal pain management plan including four elements – physical, psychological, social and pain medicines – to be developed in conjunction with a health professional.  

Dr Votrubec believes the guide will be extremely helpful in educating patients, as well as providing guidance for GPs and relieving some of their burden in terms of starting a discussion of the issue.
 
‘I think it’s absolutely marvellous, particularly where it deals with action plans, specifically pain management plans, addressing physical and psychological, social factors,’ she said.
 
‘I love the box [on the guide] that says, “Ask your health professional, how long will the pain last, how much will this medicine reduce the pain?” – not that too many of us can answer that too quickly, but at least it brings up the conversation.’
 
Dr Votrubec also appreciates the information provided by the resource regarding subjects like storage and disposal of opioids.
 
‘Because patients are being sent home with opioids that either get regularly used like an antibiotic and then they ask for more or, worse still, are put in the cupboard and being used for other things, or maybe used by other non-patients for other reasons,’ she said.
 
Associate Professor Morris hopes to see the resource widely distributed and used throughout the country.
 
‘This is the first time in Australia the Choosing Wisely 5 Questions model has been used to drive conversations about a specific treatment in a format that can be distributed in hospitals, in primary care and can be accessed directly by consumers and carers,’ he said.
 
‘Ultimately, we hope to see this practical guide provided to everyone in Australia who is prescribed an opioid medicine.’
 
The resource has been released in conjunction with NPS MedicineWise’s national education program for healthcare professionals and consumers, ‘Opioids, chronic pain and the bigger picture’, which provides resources and tools designed to help reduce opioid harms and provide effective pain management.

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Choosing Wisely Hospital care NPS Medicinewise Opioid prescribing Opioids Pain management

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