Cette année, parmi les 10 projets présentés que le groupe de travail Recherche a été étudié et évalué avec attention, le projet de M. Marcel Rainer, pharmacien, Kantonsspital Baden a été choisi avec le titre:
iPROACTIVE: Interprofessional Partnership in Reduction of Opioid-related Adverse Consequences Through InnoVative Efforts
Brève description du projet
Hypothesis: We propose an interprofessional project targeting post-operative pain management with a focus on opioids. The primary objective of this new transitional pain service is a standardization to improve medication safety, patient care, and post-operative satisfaction. This is the first opioid stewardship program in Switzerland to involve physicians, nurses, and pharmacists. We expect that the development of an interprofessional team will result in optimized pain management and reduced outpatient opioid consumption without compromising patient satisfaction.
Rationale: Among all post-operative patients, more than 70% are prescribed opioids after discharge. Specially, these patients are vulnerable to adverse drug events. Nearly 30% of all discharged patients experience adverse events, more than two-thirds of which would have been either preventable or manageable. We have therefore chosen a setting that is vulnerable to drug-related problems, the transition of care, which the World Health Organization has identified as one of three key areas for action. Both opioid-naïve and tolerant patients may receive opioids on discharge without information about the duration of analgesic therapy and/or clear tapering strategies. Various trials have consistently shown significant reductions of persistent opioid use for non-cancer pain at hospital discharge, of prescription sizes and of unnecessary opioid prescribing. Implementations were mainly supported by a pharmacist and study nurses. Thus, as an interprofessional team, we aim to intervene at the stage of hospital discharge, which has neither been shown to be associated with a “spill-over effect” to other potentially inappropriate drugs nor worse pain outcomes.
Expected results: A standardized discharge of post-operative patients can reduce the number of opioid prescriptions, persistent opioid drug use, oral morphine milligram equivalent doses, and aid in patient satisfaction and monitoring of analgesic efficacy as well as possible adverse drug reactions.
Impact on practice: This interprofessional project enables surgeons, physicians, nurses, and pharmacists to provide a safe patient discharge with improved post-operative patient experience and appropriate prescribing of opioid analgesics. The established protocols, tapering strategies, and patient information will serve as inspiration or template for other Swiss hospitals.
Description complète du projet
Entreprises partenaires du projets recherche 2023: