The Impact of an Educational Program on Patient Practices for Safe Use, Storage, and Disposal of Opioids at a Comprehensive Cancer Center

• Published in: The oncologist (Dayton, Ohio) Vol. 22; no. 1; pp. 115 - 121
• Main Authors: de la Cruz, Maxine, Reddy, Akhila, Balankari, Vishidha, Epner, Margeaux, Frisbee‐Hume, Susan, Wu, Jimin, Liu, Diane, Yennuraialingam, Sriram, Cantu, Hilda, Williams, Janet, Bruera, Eduardo
• Format: Journal Article
• Language: English
• Published: United States Wiley-Blackwell 01-01-2017
• Subjects: Adult; Analgesics, Opioid - adverse effects; Cancer; Cancer Pain - complications; Cancer Pain - drug therapy; Drug Storage; Female; Humans; Male; Middle Aged; Neoplasms - complications; Neoplasms - drug therapy; Neoplasms - epidemiology; Neoplasms - pathology; Opioid disposal; Opioid storage; Opioid use; Opioid-Related Disorders - complications; Opioid-Related Disorders - pathology; Outpatients - education; Palliative Care; Patient education; Symptom Management and Supportive Care; Opioid disposal; Patient education; Opioid storage; Opioid use; Cancer
• ISSN: 1083-7159; 1549-490X
• DOI: 10.1634/theoncologist.2016-0266

Background
Improper use, storage, and disposal of prescribed opioids can lead to diversion or accidental poisoning. Our previous study showed a large proportion of cancer patients have unsafe opioid practices. Our objective was to determine whether an improvement occurred in the patterns of use, storage, and disposal of opioids among cancer outpatients after the implementation of a patient educational program.
Patients and Methods
Our palliative care (PC) clinic provides every patient with educational material (EM) on safe opioid use, storage, and disposal every time they receive an opioid prescription. We prospectively assessed 300 adult cancer outpatients receiving opioids in our PC clinic, who had received the EM, and compared them with 300 patients who had not received the EM. The previously used surveys pertaining to opioid use, storage, and disposal were administered, and demographic information was collected. Sharing or losing their opioids was defined as unsafe use.
Results
Patients who received EM were more aware of the proper opioid disposal methods (76% vs. 28%; p ≤ .0001), less likely to share their opioids with someone else (3% vs. 8%; p = .0311), less likely to practice unsafe use of opioids (18% vs. 25%; p = .0344), and more likely to be aware the danger of their opioids when taken by others (p = .0099). Patients who received the EM were less likely to have unused medication at home (38% vs. 47%; p = .0497) and more likely to keep their medications in a safe place (hidden, 75% vs. 70%; locked, 14% vs. 10%; p = .0025).
Conclusion
The use of EM on opioid safety for patients with advanced cancer was associated with improved patient‐reported safe opioid use, storage, and disposal.
Implications for Practice
Prescription opioid abuse is a fast‐growing epidemic that has become more prominent recently, even in the cancer pain population. A previous study reported that 26% of cancer outpatients seen in the supportive care center either lose their pain medications or share their pain medications with someone else. This study demonstrates that the implementation of an opioid educational program and distribution of educational material on opioid safety brings about an improvement in opioid storage, use, and disposal practices in patients being prescribed opioids for cancer‐related pain. Our study highlights the importance of consistent and thorough opioid education at every instance in which opioids are prescribed.
Improper use, storage, and disposal of prescribed opioids can lead to diversion or accidental poisoning. The present study compared 300 adult cancer outpatients receiving opioids who had also received educational material (EM) with 300 patients who had not received EM. The use of EM on opioid safety for patients with advanced cancer was associated with improved patient‐reported safe opioid use, storage, and disposal.