Making a difference in the opioid crisis, one relationship at a time
Pharmacist Stan Dyjur was a strong supporter of ACP’s new opioid assessment guidelines when they were introduced in October. He knew that pharmacists were well positioned to make a difference in the opioid crisis. He became an even stronger supporter thanks to a first-hand patient experience he was involved with in his practice.
In his initial interview of a newly-admitted patient, Stan noticed a high dose of daily oral hydromorphone, well above the threshold of 90 oral morphine equivalents per day noted in the national guidelines recommended by ACP. The patient was taking the medication for hip and back pain and—even though it was not as effective as desired—was not open to changing the dose or trying something different to manage pain.
Stan was persistent.
He noticed an order for acetaminophen that the patient was unaware of and brought this up in their second discussion. In their third discussion, the patient began to ask questions about the acetaminophen as a potential option. By their fifth discussion, the patient agreed to try a low dose of around-the-clock acetaminophen, other non-drug treatments, and a decreased dose of hydromorphone.
“I think building a relationship was key in opening the patient up to change,” said Stan. “I followed up regularly, just asking the patient how their day was going. I’m a pharmacist, so I’m always thinking about medication, but I didn’t ask about specific therapies every time—sometimes just asking them how they were doing.”
Thanks to the new treatment protocol, the patient experienced less pain and less lightheadedness. This helped the patient achieve their goals of being discharged and reunited with family.
“Did the patient initially think that cutting back on the hydromorphone would be part of that goal? It’s hard to say,” noted Stan. “But that’s our role as pharmacists, to build a relationship with our patients, figure out what their personal health goals are, apply our expertise, and introduce drug and non-drug treatments, so they can reach their goals as easily and safely as possible.”
Helping his patient was a rewarding experience for Stan—one he will always remember.
“It was amazing,” he said. “I always try to think that if it was my family member or a loved-one in the hospital, what would I want the pharmacist to do? When you see what you’re able to do for a patient, from the family point of view, it’s why I got into the profession. I sometimes wonder if what I do makes a difference. Interventions like this don’t happen with every patient interaction, but when they do, it’s pretty special.”