Pharmacists' role in opioid safety: A focus group investigation

Objective. The pharmacist's role and responsibilities in addressing the opioid epidemic have yet to be clearly defined, particularly from the patient's point of view. This qualitative study explores the pharmacist's role in promoting opioid safety from the perspective of pharmacists and patients. Design. Focus groups. Setting. Patient groups were held in person, and pharmacist groups were held online. Subjects. Oregon pharmacists (N=19, M_age = 39.0 years, range=26-57 years, 58% female) and patients (N=18, M_age=60.1 years, range=30-77 years, 71% female) with current experience dispensing or receiving opioid medications. Methods. Pharmacists were asked about the challenges and opportunities for opioid safety monitoring and prescription dispensing. Patients were asked about their experiences accessing care, medications, and safety information. Focus group data were analyzed by a multidisciplinary team using an immersion-crystallization approach. Results. Pharmacists and patients agreed that pharmacists are responsible for medication safety. Pharmacists expressed discomfort filling potentially high-risk opioid prescriptions and noted barriers such as lack of clinical information and discomfort policing high-risk prescribing. Patients were concerned about pharmacists potentially overstepping their professional responsibilities by interfering with prescribers' clinical decisions. Conclusions. Feedback from both pharmacists and patient participants suggests that there is uncertainty in the degree to which pharmacists can and should confront the prescription opioid epidemic directly. Ambiguities in the pharmacist's role may be best clarified through structured training promoting enhanced between-party communication.