The ONE Program

Project name: Community and Clinical Collaboration for Opioid Misuse and Overdose Prevention

Investigators:

Jayme Steig, PharmD
Mark Strand, PhD, CPH
Amy Werremeyer, PharmD, BCPP
Heidi Eukel, PharmD
Oliver Frenzel, PharmD, MPH
Elizabeth Skoy, PharmD

Timeline: September 2018 – present

Collaborators: NDSU, North Dakota Department of Human Services, North Dakota Community Pharmacies

Purpose: The Opioid and Naloxone Education Program (ONE) focuses on community pharmacy-based patient screening and interventions to improve population health through which pharmacists screen patients who receive an opioid prescription for the risk of opioid misuse and accidental overdose. The mission of the ONE Program is to “proactively help patients and communities by providing resources to pharmacists and patients to educate them about opioid misuse and accidental overdose”

For detailed information and to learn more about the program and its impact, visit www.one-program.org

The ONE Program was recently described in an Research Features publication: Using opioid riskscreening to combat the opioid epidemic.

What is already known on this topic?
Opioid misuse and overdose remains an intractable public health problem. Increasing safe opioid use among all patients requires identifying persons at-risk of opioid harm and providing preventative services to them before harm occurs. Community pharmacists interact with every patient receiving an opioid prescription, and thus are able to provide interventions to ensure safe medication use and prevention of opioid misuse.

What is the impact of this project on collaboration and advancement in pharmacy?
The ONE Program as shown the essential role that community pharmacists play in opioid misuse and overdose prevention. It has also shown the importance of integrating community pharmacy practice into public health initiatives across the state of North Dakota, aligning pharmacy with preventative care initiatives.

What is the impact of this project on improving population health?
The ONE Program addresses a significant patient safety problem and has the potential to decrease a high cost burden medication safety issue. The ONE Program includes a sustainable and evidence based tool/process that is easily transferred and adapted to meet each pharmacy’s need. The ONE Program has positively changed pharmacist practice-based behaviors, decreased pharmacist stigma towards patients, has increased naloxone dispensing to those at risk, and has shown significance against population-level evaluations.

image of ONE Program process

What publications, presentations, posters, and follow up grants did this work lead to?

Refereed Publications

Werremeyer A, Mosher S, Eukel H, Skoy E, Steig J, Frenzel O, Strand MA. Pharmacists’ Stigma Toward Patients Engaged in Opioid Misuse: When ‘Social Distance’ Does Not Mean Disease Prevention. Substance Abuse. Published online March 22, 2021.

Frenzel O, Eukel H, Skoy E, Werremeyer A, Steig J, Strand M. Examining Attitudes and Beliefs that Inhibit Pharmacist Implementation of a Statewide Opioid Harm Reduction Program. INNOVATIONS in Pharmacy. 2020:11(4).

Eukel H, Steig J, Frenzel O, Skoy E, Werremeyer A, Strand M. Opioid Misuse and Overdose: Changes in Pharmacist Practices and Outcomes. Journal of Continuing Education in Health Professions. 2020: 40(4): 242-247.

Skoy E, Werremeyer A, Eukel H, Frenzel O, Steig J, Strand M. Patient Acceptance of Naloxone Resulting from Targeted Intervention from Community Pharmacists to Prevent Opioid Misuse and Accidental Overdose. Journal of the American Pharmacists Association. Accepted, August 2020.

Skoy E, Eukel H, Werremeyer A, Strand M, Frenzel O, Steig, J. Implementation of a Statewide Program within Community Pharmacies to Prevent Opioid Misuse and Accidental Overdose. Journal of the American Pharmacists Association. 2020: 60(1) 117-121.

Strand M, Eukel H, Frenzel O, Skoy E, Steig J, Werremeyer A. Program Evaluation of the Opioid and Naloxone Education (ONE Rx) Program Using the RE-AIM Model. Research in Social and Administrative Pharmacy. 2020; 16:1248-1254.

Strand M, Eukel H. A Primary Prevention Approach to the Opioid Epidemic. American Journal of Public Health. 2019: 109 (6).

Werremeyer A, Skoy E, Marvanova M, Jarajapu Y, Brynjulson R, Wilhelm R, Eukel H. A PharmD Program Curricular Approach to Addressing the Opioid Crisis. Currents in Pharmacy Teaching and Learning. 2019: 11 (6).

Skoy E, Eukel H, Frenzel J, Werremeyer A. Preparing Student Pharmacists to Identify Opioid Misuse, Prevent Overdose, and Prescribe Naloxone. Currents in Pharmacy Teaching and Learning. 2019: 11 (5).

Eukel H, Skoy E, Werremeyer A, Burck S, Strand M. Changes in Pharmacists’ Perceptions Following a Training in Opioid Misuse and Accidental Overdose Prevention. Journal of Continuing Education in the Health Professions. 2019: 39(1):1.

Strand MA, Eukel H, Burck S. Moving opioid misuse prevention upstream: A pilot study of community pharmacists screening for opioid misuse risk. Research in Social and Administrative Pharmacy. 2019: 15(8) 1032-1036

Professional Presentations

Strand MA, Eukel H, Frenzel O, Skoy E, Steig J, and Werremeyer A. Evaluation of a Statewide Rollout of an Opioid Misuse Prevention Program in Community Pharmacies Using the RE-AIM Model. American Public Health Association Annual Meeting and Exposition, San Francisco, CA; November 2020.

Frenzel O, Strand M, Eukel H, Werremeyer A, Skoy E, Steig J. Implementation of ONE Rx: Using the Transtheoretical Model in Detailing Patient-Centered Opioid and Naloxone Education in our Community Pharmacies. American Public Health Association Annual Meeting. Philadelphia, PA; October, 2019.

Strand M, Frenzel O, Eukel H, Werremeyer A, Skoy E, Steig J. Applying Social Support Theory at the Community Pharmacy Level in the Prevention of Opioid Misuse and Overdose. American Public Health Association Annual Meeting. Philadelphia, PA; October, 2019.

Steig J, Strand M, Eukel H, Skoy E, Werremeyer A, Frenzel O. ONE Rx: Community Pharmacy Based Screening and Interventions for Opioid Overdose and Opioid Use Disorder. American Health Quality Association Quality Summit, October 2019; Baltimore, MD.

Skoy E, Werremeyer A, Eukel H. Strand M. Preventative Screening for Opioid Misuse and Accidental Overdose: Implementation of a Statewide Pharmacy CPD Program. American Association of Colleges of Pharmacy Annual Meeting, July 2019; Chicago, IL.

Werremeyer A, Strand M, Eukel H, Skoy E, Steig J. Pharmacists and opioids in their communities—ONE Rx. Webinar Presentation for Project ECHO ND. April 2019

Frenzel O, Eukel H, Strand M. Preventing Opioid Misuse at the Community Pharmacy Level: Update on the ONR Rx Project. Podium presentation to be given at Dakota Conference, 2019.

Werremeyer A, Eukel H, Frenzel O, Skoy E, Strand M, Steig J. Pharmacists and Opioids in their Communities – A New Way to Look at a Long-Term Problem. Podium presentation to be given at the North Dakota Family Based

Strand MA and Eukel H. (April 20, 2018) Roundtable discussion about Opioid Misuse Risk Prevention Toolkit. 133rd Annual NoDak Pharmacy Convention, Fargo, ND.

Strand MA and Eukel H. (June 13-15, 2018) “Moving Opioid Misuse Prevention Upstream: Opportunities for Pharmacists.” Oral presentation made at the 33rd Annual Dakota Conference on Rural and Public Health, Alerus Center, Grand Forks, ND.

Refereed Poster Presentations

Werremeyer A, Eukel H, Skoy E, Steig J, Strand M. Creating Long-Lasting Stigma Reduction among Community Pharmacists. Stigma of Addiction Summit Innovation Abstract Compendium. June, 2021.

Steig J, Strand M, Eukel H, Skoy E, Werremeyer A, Frenzel O. ONE Rx: Community Pharmacy Based Screening and Interventions for Opioid Misuse and Accidental Overdose. National Association of Board of Pharmacy Virtual Educational Poster Session. June 2020.

Skoy E, Eukel H, Werremeyer A, Frenzel O, Steig J, Strand M. Program Outcomes of a Statewide Approach to Screen for Opioid Misuse and Accidental Overdose within Community Pharmacies. The American Pharmacists Association Annual Meeting. March 2020. Held via virtual poster gallery due to COVID-19.

Eukel H, Steig J, Frenzel O, Skoy E, Werremeyer A, Strand M.  Opioid Misuse and Overdose: Changes in Pharmacist Practice and Outcomes.  Refereed poster to be presented at American Association for the Treatment of Opioid Dependence Annual Meeting.  April 2021; Las Vegas, NV.

Werremeyer A, Eukel H, Strand M, Skoy E, Steig J. Integrating the Community Pharmacist in Upstream Prevention of Opioid Misuse and Accidental Overdose. Poster Presentation at American Association for the Treatment of Opioid Dependence Annual Meeting. October 2019; Orlando, FL.

Eukel H, Werremeyer A, Frenzel O, Skoy E, Steig J, Strand M. Pharmacists Taking Action: Screening Patients for Opioid Misuse and Accidental Overdose Within Community Pharmacies. Poster presentation at American Association for the Treatment of Opioid Dependence Annual Meeting. October 2019; Orlando, FL

Mosher S, Werremeyer A, Strand M, Eukel H, Skoy E. Assessing Social Distance Between Pharmacists and Patients with Substance Use Disorder. Poster Presentation at College of Psychiatric and Neurologic Pharmacists Annual Meeting. April 2019; Salt Lake City, UT

Skoy E, Eukel H, Strand M, Werremeyer A, Steig J, Frenzel O.  Screening Patients for Opioid Misuse and Accidental Overdose Within Community Pharmacies. American Pharmacists Association annual meeting, Mach 2019; Seattle, WA.   

Skoy E, Eukel H, Strand M, Werremeyer A, Steig J, Frenzel O.  Screening Patients for Opioid Misuse and Accidental Overdose Within Community Pharmacies.  Invited research plenary discussion. American Pharmacists Association annual meeting, Mach 2019; Seattle, WA.    

Strand M, Eukel H, Werremeyer A, Skoy E, Steig J, Frenzel O. Applying Social Support Theory at the Community Pharmacy Level in the Prevention of Opioid Misuse and Overdose. Poster to be presented at American Public Health Association annual meeting, 2019.

Tupper E, Skoy E, Eukel H, Strand M, Werremeyer A, Steig J, Frenzel O. Patient Acceptance of Pharmacist-Prescribed Naloxone – Which Risk Factors Matter Most? Poster to be presented at American Pharmacists Association annual meeting, 2019.

Strand MA, Burck S, Eukel H. (Nov 11, 2018) A Toolkit for Screening for Opioid Misuse in the Community Pharmacy. Poster presentation at the 146th annual meeting and Exposition of the APHA, San Diego, CA.

Burck S, Strand MA, Eukel H. (June 13-15, 2018) Attitude changes of pharmacists after participating in an opioid misuse prevention training. Poster presentation made at the 33rd Annual Dakota Conference on Rural and Public Health, Alerus Center, Grand Forks, ND.

Strand MA, Burck S, Eukel H. (Nov 11, 2018) A Toolkit for Screening for Opioid Misuse in the Community Pharmacy. Poster presentation at the 146th Annual Meeting and Exposition of the APHA, San Diego, CA.

Grants

Eukel H, Strand M, Skoy E, Steig J, Werremeyer A. Community and Clinical Collaboration for Opioid Misuse and Overdose Prevention. North Dakota Department of Human Services. October 2020 – September 2021. $283,935

Eukel H, Strand M. Public Health Nursing Supporting Safe Opioid Use through ONE Rx $15,000

Strand M, Eukel H, Werremeyer A, Skoy E, Steig J.  Primary prevention of opioid misuse and accidental overdose across North Dakota.  North Dakota Department of Human Services. September 2019 – August 2020. $221,887 

Eukel H, Strand M, Werremeyer A, Skoy E, Steig J. Opioid Misuse and Overdose Risk Prevention Expansion. North Dakota Department of Human Services. January 2019 – September 2019. $141,000

Strand MD, Eukel H, Werremeyer A, Skoy E, Steig J. Community Pharmacy Opioid Misuse Risk Prevention toolkit project. Alex Stern Family Foundation. May 2018 – December 2019. $15,000

Strand MD, Eukel H, Werremeyer A, Skoy E, Steig J. Community Pharmacy Opioid Misuse Risk Prevention toolkit project. North Dakota Department of Human Services. May 2018 – December 2019. $116,468

Strand MD, Eukel H, Werremeyer A, Skoy E, Steig J. Community Pharmacy Opioid Misuse Risk Prevention toolkit project. Blue Cross Blue Shield of North Dakota Caring Foundation. May 2018 – December 2019. $19,000

Strand MD, Eukel H. Pharmacist Engagement in the community to Target Opioid Abuse Prevention. FM Area Foundation and the North Dakota Board of Pharmacy. June 2017. $11,078