ASHP InterSections ASHP InterSections

September 30, 2019

ASHP Opioid Task Force Focuses on Role of Pharmacists in Combating Opioid Crisis

Paul W. Abramowitz, Pharm.D., Sc.D. (Hon.), FASHP

This week we look forward to convening an Opioid Task Force meeting to address the important roles pharmacists play in combating the opioid crisis, a multifaceted issue that requires sustained efforts by all members of the interprofessional care team. While no easy fixes exist to end the opioid epidemic, ASHP and our 50,000 members have been working diligently to shape the solutions around opioids through the engagement of pharmacists on behalf of our patients and communities. Still, there is far more work to be done.

The interdisciplinary ASHP Opioid Task Force, chaired by Past President Lisa Gersema, is charged with identifying actionable solutions, tools, and resources to help address the national opioid epidemic through the engagement of pharmacists as medication therapy experts, clinicians, and providers on the interprofessional team. Key areas of focus include:

  • Identifying the roles that pharmacists play in initiating, building, and growing opioid stewardship.
  • Identifying best medication-related pain management prescribing practices that optimize the use of non-opioid therapies.
  • Identifying the public health roles that pharmacists play in their communities as related to the prevention and treatment of opioid use disorders.
  • Developing recommendations on a solutions-focused public policy agenda.
  • Identifying education, tools, and other resources to help hospitals and health systems address the opioid crisis, including in areas related to drug diversion prevention and mitigation.

The ASHP Opioid Task Force will examine how pharmacists can drive practice changes, community-wide opioid-related efforts, and policy solutions. The recommendations will be reinforced by the breadth and depth of expertise of each Task Force member, many of whom have direct experiences with developing opioid stewardship programs, policies to increase access to medication-assisted treatment, opioid-related community programs, and shaping the national agenda to address the epidemic. The Task Force will be working to finalize its recommendations in the forthcoming months. The outcomes of the Task Force will be published in a spring issue of the AJHP and shared widely with our membership, partners, and external stakeholders.

As discussed in a previous blog, ASHP is a sponsoring member of the National Academy of Medicine (NAM) Action Collaborative on Countering the U.S. Opioid Epidemic. ASHP will be sharing the outcomes of the Task Force with NAM to contribute and support the larger national dialogue around opioids. ASHP serves on the Action Collaborative’s Pain Management Guidelines and Evidence Standards Working Group and Prevention, Treatment, and Recovery Services Working Group. As the Action Collaborative works to further synthesize and amplify evidence-based medicine to prevent and manage opioid use disorder, ASHP is committed to highlighting the role of the pharmacist throughout.

We look forward to sharing more about our work with the ASHP Opioid Task Force and on ASHP’s ongoing efforts surrounding the opioid crisis, including creating various tools, education, and resources to support you in your practice.

As this work moves forward, I urge you to review ASHP’s current resources on the topic, including our toolkits on pain managementcontrolled substances management, and opioid management.

Click here to view the complete ASHP Opioid Task Force roster.

Thank you for being a member of ASHP, and for everything that you do for your patients.

Sincerely,

Paul

September 17, 2019

Young Pharmacists Show that Helping Others is a Prescription for Well-Being

Emily Belarski, Pharm.D., goes hiking to decompress after a stressful day.

BURNOUT IS BECOMING INCREASINGLY COMMON among early career pharmacists. A study published in AJHP found that pharmacy residents working more than 60 hours per week reported high levels of stress, depression, and hostility. ASHP InterSections caught up with four former ASHP externs, who were student pharmacists during their rotation experience at ASHP HQ, to learn how they integrate well-being into their busy schedules and inspire resilience among their co-residents and colleagues.

Embrace Team Power
In the middle of a relentless month of 4:30 a.m. wake-ups, long clinic hours, and late nights reading for the next day’s topic discussions during a pediatric hematology/oncology rotation in her second year of residency training, Emily Belarski, Pharm.D., felt she had to change her approach.

“The biggest thing that led to burnout during that period was having a huge knowledge gap and finding it really, really overwhelming to fill it,” recalled Dr. Belarski, who is now a General Pediatrics Clinical Pharmacist Specialist at University of Chicago Medicine’s Comer Children’s Hospital.

She was reluctant to bring it up to her preceptor, but it turned out that her preceptor was very receptive. Dr. Belarski shared her struggle, and together, they devised a plan to strengthen her clinical skills while decreasing stress. “By choosing one topic to learn about daily, rather than floundering with a long list of topics for the topic discussions, I could build my learning skills and not become overwhelmed by my knowledge gaps,” she said.

This strategy led to an a-ha moment for Dr. Belarski. “I was there to build the skills to find the answers, not just to learn the answers. That changed my outlook on residency and made me a lot less stressed,” she said.

Learners may be intimidated to ask for help in a situation like this, but reaching out to her preceptor was something Dr. Belarski wishes she had done sooner. “Talking with my preceptor at the time left me feeling that it was okay not to know everything,” she said.

Adding her preceptor to her support network also enlarged a circle that already included family, friends and, importantly, co-residents, Dr. Belarski noted.

Promote a Culture of Listening
Meredith Oliver, Pharm.D., a PGY2 infectious diseases pharmacy resident at the University of Utah Health, considers herself an advocate for resilience and well-being among the hospital’s residents.

Meredith Oliver, Pharm.D., spends time in Utah’s Wasatch National Forest after a long day in the hospital.

“As healthcare professionals in training, we have a lot of responsibilities that pull us in many directions every day,” said Dr. Oliver. “But slowing down and listening to both our colleagues and our patients is crucial to our work and the success of patient outcomes.”

Dr. Oliver said she struggled to maintain her resiliency while working with “very sick patients” and managing complex treatment regimens during a recent hematology-oncology ICU rotation. “I was having many difficult conversations about the goals of care with patients, and these were often challenging to process,” she said. “However, working alongside amazing healthcare professionals meant that I did not feel alone in fighting for my patients.”

Dr. Oliver said the experience left her wanting to help others cope with their instances of burnout, so she trained to be a peer support volunteer through the University of Utah’s Health’s Resiliency Center. The Center helps healthcare professionals, including the pharmacy program’s 25 residents, manage clinical burnout and teaches them strategies to create wellness and resilience.

One of those strategies is to grant colleagues “the space to feel heard,” said Dr. Oliver. “I’m very grateful that I can share my successes and struggles with my co-residents.”

Although personal strategies can help ensure resilience and well-being, “it needs to be paired with an organizational culture and structure to combat clinician burnout, so that we can give ourselves fully to our patients. They are what matter the most,” said Dr. Oliver.

Student Wellness Curriculum
Imagine this: as a student pharmacist, you saunter into a classroom and casually chat with your peers about a new restaurant you want to try, or a hike you’d like to take. Then you sit down for a 10-minute guided meditation.

Autumn Pinard improves her resilience by spending time outdoors.

If this sounds like a guilty pleasure in a busy student’s life, Autumn Pinard believes you should think again. “We need to make sure we take care of ourselves so that we can take care of our patients,” said Pinard, who is entering her P2 year at the University of New Mexico College of Pharmacy.

Pinard enrolled in the new elective wellness course described above to avoid burnout. “In the past, I gave too much of myself, and I wasn’t paying attention to my well-being,” she said.

In addition to helping her improve resilience, the course inspired Pinard to help other students. She is looking into being a teaching assistant (TA) for a new iteration of the course slated for the 2020 spring semester. “I want to promote resilience and well-being in school early on, before people experience burnout,” Pinard said.

She is currently waiting for confirmation of the course and the TA position. Her vision for the new curriculum is “to dedicate lots of time to exploring meditation, learning more about ourselves and our strengths, and developing emotional intelligence.”

Access to Free Counseling
When Lubna Mazin, Pharm.D., started pharmacy school at the University of Texas at Austin College of Pharmacy, access to mental healthcare required going through a vetting process, being placed on a list, and then paying for the services.

“There were a lot of barriers that prevented students from getting counseling,” said Dr. Mazin, who is currently completing a health-system pharmacy administration residency at Nationwide Children’s Hospital, Columbus, Ohio.

Lubna Mazin, Pharm.D., climbs mountains to ward off burnout and stress.

In her P3 year, after coming out of her own period of burnout and finding ways to reduce the risk of a repeat episode – primarily by maintaining a daily exercise regimen – Dr. Mazin joined the university’s Mental Health and Wellness Committee. She advocated for easier access to mental health services. The committee’s efforts paid off, and the university’s president signed off on a new policy that provided free counseling services to students.

“The free services were especially important after several tragedies took place at the school,” recalled Dr. Mazin. Students were reluctant to discuss the difficult topics that arose during those crises, Dr. Mazin noted. The counselors turned to a tried-and-true method of bringing students together—free pizza. “That got students sitting around in one place and gave counselors an opportunity to ask them how they were feeling,” she said.

Moving forward, Dr. Mazin would like to see wait times for university mental health services, particularly for those in crises, reduced. “Getting funding for that type of mental health service, even if it’s talking to someone for 15 minutes, is the next step,” she said.

 

By David Wild

 

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