- Straightforward and actionable patient education tools increase the likelihood that a patient will dispose of her left-over pain medications properly, according to a new study published in Journal of the American College of Surgeons.
Opioids have proven an effective pain management strategy that yields both patient comfort and patient satisfaction with care. However, patients are often prescribed more pills than they actually need, leaving patients with extra tablets.
Those extra tablets are often credited with the spread of the opioid and heroin epidemic current gripping the country.
Opioids are a gateway drug for heroin, and 70 percent of opioid users obtained their most recent opioids peripherally from a family member or friend’s left over supply, according to the researchers from Washington University School of Medicine and Barnes Jewish Hospital.
"There is strong data indicating that prescription opioid use is a risk for heroin use," said study coauthor Katherine B. Santosa, MD. “Initiation of misuse occurred through three main sources: family, friends, or personal prescriptions.”
The researchers sought to develop a patient education brochure that would help surgical patients appropriately discard their left-over opioids. The brochure development team included attending surgeons, a clinical fellow, a nurse practitioner, a research nurse coordinator, and patient service and education administrators.
The team developed a tool that is straightforward, reconciling best practices for opioid disposal from leading institutions including the Food and Drug Administration.
The brochure touched upon key facts regarding the opioid crisis, the risks of left-over opioids for drug misuse, and step-by-step instructions for disposing of opioids in the trash. The brochure also listed resources for drug take-back locations.
Specifically, the brochure described an at-home best practice for opioid disposal. Patients should mix left-over opioids with an undesirable household item such as soil, kitty litter, or discarded coffee grounds. Other strategies include mixing the opioids with liquid dish soap in a plastic bag.
The team tested brochure efficacy on 334 surgical patients, issuing the brochure to an intervention cohort of 170 patients. Twenty-two percent of the intervention group patients reportedly disposed of their left-over opioids correctly, while only 11 percent of those from the control group did.
While these results are encouraging, the researchers said they are identifying strategies for improving the patient education process regarding opioid disposal, including refining the brochure for simplicity.
"We were encouraged by our findings and have now designed and are testing an even more straightforward one-page brochure to see if disposal will be even more efficient," said research team member Jessica Hasak, MPH. “Our thought was that the simpler and easier for the patient the instructions and disposal method can be, the more likely we as medical practitioners will be to empower them to do something about the problem.”
The researchers are working to quell the opioid epidemic through patient education. In 2015, over 33,000 deaths were attributed to opioid misuse, and that number increased by 21 percent by 2016, the researchers reported citing numbers from the Centers for Disease Control (CDC).
While many education strategies highlight the dangers of opioid misuse in general, this project looks at all aspects of the opioid crisis.
Opioids can be effective in helping patients, reducing pain, and increasing patient satisfaction. In some cases, opioid prescribing is necessary, and healthcare professionals must instead focus on ensuring the drugs land in the correct hands only.
“Our big goal is to empower everyone to potentially save a life of a young person by getting a national campaign led from the ground up to clean these drugs out of medicine cabinets," said coauthor Susan E. Mackinnon, MD, FACS.
Ultimately, the research team hopes to see their efforts turn into a national campaign that can help patients across the country.
"Considering that early exposure to opioid pain medications is a significant risk for future use of illegal substances, we must empower everyone, perhaps through a national campaign, to get these dangerous drugs out of American medicine cabinets,” Santosa concluded.