Development of Leftover Opioids Management System in Patients Receiving Palliative Care
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Abstract
Background: There were patients who got a palliative care and accessed to opioids approximately 589 kg bass a year in Thailand, but leftover opioids because of patients died or stop taking may misuse, addictive, or distribute become drugs to societies.
Objectives: The study aimed to develop a leftover opioids management system in patients who got palliative care and to study an economic impact on the leftover opioids.
Methods: The study was a research and development that operated between 1 January and 31 December 2019 at Thawangpha hospital and primary healthcare units in Tha Wang Pha District, Nan province, Thailand. The research process consists of four steps as follow: analyzed the problem situations and the assess needs by collecting data through in-depth interviews and reviewing relevant literature, created and developed the leftover opioids management system model in patients receiving palliative care, experimented the model, and evaluated and improved the leftover opioids management system appropriately to implementation and ready to practice in the future.
Results: The research found that the leftover opioids management system model consisted of five components which were (1) the creation database of patients who accessed opioids in palliative care, (2) the education program to the patients and their relatives about using opioids and management of leftover opioids, (3) building healthcare networks to monitor the opioids using in communities, (4) making the leftover opioids return system when the patients stop using or die, and (5) imposed an important policy of the Pharmacy and Therapeutics Committee at Thawangpha hospital. This model effected on amounts, cost, and return rate of leftover opioids. It found that after implementation, the amount of leftover opioids returning increased from 235 to 1,213 tablets and a total value of leftover opioids rose from 4,930 to 20,088 baht. Besides, the return rate of leftover opioids grew from 31.6 to 100%.
Conclusions: The leftover opioids management system model in patients receiving palliative care was able to increase the rate of highly leftover opioids returning, which it reduced the risk of drug abused and increased safety from healthcare services.
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