Laura Morgan

The Use of Prescription Monitoring Programs to Reduce Opioid Diversion and Improve Patient Safety

ABSTRACT An increase in the prescribing of opioids in an effort to improve management of chronic pain has led to enhanced availability of controlled substances for diversion and abuse. Evidence suggests that the use of prescription monitoring programs (PMPs) may help curtail this growing public health issue. The current use of PMPs varies widely from state to state but there have been important changes improving interconnectivity of PMPs across states. This paper describes current data on the effect of prescription monitoring programs on reducing abuse and diversion of controlled substances. It also offers suggestions on how PMPs may be incorporated into practice and clinical decision-making to ensure appropriate pain management and patient safety.

Fibromyalgia: Diagnosis and Management for the Primary Healthcare Provider

Fibromyalgia is a disorder of chronic generalized musculoskeletal pain affecting 2% of the general population, with an increased frequency in women. Clinical diagnosis relies on history and research-supported tender point criteria. As in other chronic pain syndromes, a multidimensional approach optimizes treatment response. Empirical data and consensus support the use of nonpharmacological modalities, such as education, aerobic exercise, and cognitive behavioral therapy, in the management of fibromyalgia. Evidence-supported pharmacological interventions include tricyclic antidepressants, serotonin-norepinephrine reuptake inhibitors, selective serotonin reuptake inhibitors, alpha-2-delta ligands, and other serotonergic-noradrenergic analgesic agents, such as tramadol. This paper offers the primary healthcare provider a systematic approach to the diagnosis of fibromyalgia and management strategies based on available evidence, consensus, and empirical data.

An Active-Learning Laboratory on Immunizations

Objective. To implement and evaluate an active-learning laboratory activity to teach pharmacy students about influenza, pneumococcal, and shingles vaccines. Design. The laboratory session was divided into 6 immunization stations: 3 stations on influenza including a pediatrics station, and 1 station each for pneumococcal, shingles, and anaphylaxis. Assessment. Although 118 of 123 (95.9%) students had completed an immunization training certificate prior to attending the laboratory, the average score on a pre-assessment to measure immunization knowledge and confidence was 56%. The post-assessment score was 87.4%. Students’ confidence improved by 18.7% to 51.2% in each of the 5 areas assessed. Most respondents rated the activity overall as good or excellent on a post-activity evaluation. Conclusion. An active-learning approach to teaching immunizations allowed students to gain knowledge in simulated real-world experiences and reinforced key concepts on influenza, pneumococcal, and shingles vaccines.