Year of Publication

2018

College

Martin School of Public Policy and Administration

Date Available

10-10-2018

Degree Name

Master of Public Administration

Executive Summary

The United States is in the throes of an opioid epidemic. Any person who uses an opioid medication may experience an intentional or unintentional overdose. An overdose is more likely to occur when an individual ingests an opioid in combination with certain classes of medications, such as benzodiazepines or nonbenzodiazepines (Z-drugs). These medications are more likely to cause sedation and respiratory depression when taken together. Veterans, due to their unique mental and physical health challenges, are more likely to experience an overdose when they receive a combination of opioid therapy with benzodiazepine or Z-drug therapy as opposed to a single prescription for either medication.

This descriptive analysis explores the efforts of pharmacists at the Lexington Veterans Affairs MedicalCenter (VAMC) to reduce concomitant prescribing rates within their institution. Their approach is modeled after another VAMC within their regional cohort that reduced its number of concomitant prescriptions drastically within one calendar year. To assess the efficacy of pharmacist-led provider education efforts, I evaluated concomitant prescribing consultations and interventions for 50 patients. The results of the analysis show a numeric reduction in the number of patients receiving both opioids and benzodiazepines or Z-drugs. The primary goal of prescribing reduction is an increase in patient safety, but the analysis also shows potential for significant cost savings.

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