Opioid Risk Mitigation and Naloxone Training: An Interprofessional Pilot with Pharmacy, Dental, and Medical Students

Background:
The opioid crisis requires coordinated effort from health professions educators to provide students from all disciplines with the tools and skills to recognize potential opioid abuse and to effectively mitigate risks associated with controlled substances. Health practitioners must also be able to educate patients at elevated risk, recognize the signs and symptoms of opioid overdose, and administer naloxone when clinically indicated.
Since the professional roles of physicians, dentists and pharmacists regularly intersect clinically around the assessment and treatment of pain, interprofessional learning activities involving medical, dental and pharmacy schools can be an effective way to promote collaboration that reduces individual risk, and improves public health outcomes related to the opioid crisis.

Methodology:
Faculty from the MCPHS University, School of Pharmacy-Boston, Tufts School of Dental Medicine (TUSDM), and Tufts University School of Medicine (TUSM), developed a teaching case for a faculty-facilitated small-group IPE activity focused on the management of acute dental pain in the context of elevated opioid overdose risk. Key learning points were tied to pain assessment, recognition of medical and psychosocial risk factors, lower-risk pain management strategies, and patient education. A naloxone demonstration with hands-on participation was also included. Evaluation included a pre/posttest knowledge and attitudes instrument (medical/dental) and an IPEC competency-based instrument (IPAS, pharmacy.

Results:
The IPE occurred over two, half-day sessions (February 2019) at the MCPHS University Boston Campus and involved the entire cohort of PY-3 MCPHS pharmacy students (300), the entire cohort of second year TUSM medical students (200), and a mixed cohort of TUSDM dental students (80). Faculty from all schools facilitated mixed groups of students in small group settings. Outcome measures demonstrated knowledge acquisition and positive attitudes toward interprofessional learning.

Conclusion:
Opioid risk mitigation and naloxone training can be successfully addressed with a mixed-discipline, small-group, case-based IPE activity in the pharmacy didactic curriculum.

Reflections/lessons learned/implications:
Overall, student and faculty feedback was positive and reflected a desire for more interprofessional clinical case learning. Logistics, scheduling, space issues and preparation/coordination of numerous faculty facilitators, posed significant challenges.