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Mailed at-home disposal kits enhance disposal charges of unused opioids after surgical procedure

Mailed opioid disposal kits led to 60 p.c of sufferers who had leftover opioid ache capsules correctly disposing of them after surgical procedures, in accordance with a brand new examine by researchers on the Perelman Faculty of Medication on the College of Pennsylvania. Simply 43 p.c of sufferers on this examine who did not obtain the kits disposed of their opioids, however when in comparison with nationwide research, the mailed package group on this analysis appeared to double and even triple the beforehand seen charges of protected disposal. Pointing to a probably efficient technique for chopping down on a supply of illicit opioids, this examine was printed at the moment in JAMA Community Open.

I used to be happy to see that such a easy, ‘snail mail’ strategy may change habits and promote self-reported disposal. The opioid epidemic clearly continues to be entrance and middle for sufferers, and the issues with opioid use and misuse have gotten an actual a part of the dialog between physicians and sufferers. I feel sufferers are extra conscious of the dangers and penalties of utilizing opioids and storing them of their houses.”

Anish Agarwal, MD, examine’s lead writer, assistant professor of Emergency Medication and chief wellness officer of the Division of Emergency Medication at Penn Medication

Leftover opioid drugs are a priority for his or her potential to be misused, both by the particular person they have been prescribed to or another person taking them. However simply throwing leftover capsules into the trash might not be the best choice.

“Throwing them within the trash could be harmful if tabs are ingested by children or animals, and there are environmental issues,” stated the examine’s senior writer, M. Equipment Delgado, MD, an assistant professor of Emergency Medication and Epidemiology and deputy director of the Penn Medication Nudge Unit. “When protected disposal website are usually not obtainable, the FDA recommends that sure high-risk drugs, together with opioids, be flushed down the bathroom as a result of their high-risk nature. Nonetheless, there are additionally environmental issues with doing this.”

Whereas protected disposal websites, like sure pharmacies, are the best choice, sufferers usually do not use them as a result of they might not be simply accessible or it takes additional effort. So Agarwal, Delgado, and colleagues determined to check whether or not an added layer of comfort – mailing protected disposal kits – would possibly make a distinction.

Happening between April 19 and June 1, 2021, the examine consisted of 235 sufferers who accomplished it. All these contributors had an orthopedic or urologic process and have been prescribed opioid ache treatment for his or her restoration. Break up roughly in half, the standard process was utilized to at least one group: They have been texted directions to eliminate their unused opioids together with a hyperlink detailing the places of native protected disposal factors to drop off their unused opioid tablets. The second group acquired the identical textual content message directions but additionally acquired mailed disposal kits 4 to seven days after their procedures.

Some nationwide research present that solely about 20 to 30 p.c of sufferers correctly eliminate their additional opioids, which signifies that the influence of the mailed kits – growing these numbers to 60 p.c – might be even higher than noticed on this examine. On high of that, despite the fact that the mailed package group of sufferers solely consisted of 125 sufferers, the intervention resulted within the protected disposal of 480 unused tablets.

“It is a smaller examine, however eradicating nearly 500 opioid tablets out of drugs cupboards and out of communities the place they might do hurt might be impactful,” stated Agarwal. “One may think about that if scaled as much as the hundreds of surgical procedures which might be executed per 12 months in our well being system and tens of millions executed within the U.S., how this might be extraordinarily impactful at scale.”

Mailing the kits shouldn’t be “prohibitively costly,” Agarwal stated, as they value as much as $2 every.

“We’re wanting into methods to increase our attain and probably discover different distribution strategies,” Agarwal stated. “Probably the most rewarding a part of my job is that our analysis group additionally serves in key operational roles for the well being system’s opioid job drive, in addition to different essential initiatives to make sure we’re treating sufferers’ ache, optimizing prescribing based mostly on affected person suggestions, and making it straightforward to make evidence-based selections. It is nice to construct modern approaches and consider them in real-time.”

The examine matches right into a wider effort to curb the opioid epidemic on the well being system stage.

“In parallel to our efforts to optimize how we distribute these kits to sufferers, comparable to immediately handing them to them upon discharge or at prescription fill, we should additionally make efforts round shared decision-making and right-sizing prescriptions to satisfy affected person wants,” Delgado stated.

Kits used on this examine have been offered by an in-kind donation from DisposeRx.

The examine was supported by the Meals & Drug Administration (HHSF223201810209C).


Journal reference:

Agarwal, A.Okay., et al. (2022) Impact of Mailing an At-home Disposal Equipment on Unused Opioid Disposal After Surgical procedure. JAMA Community Open.


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