A Cross-Sectional Evaluation of Opioid Dispensing Competencies in Final-Year Pharm-D Students: A Multicenter Study from Punjab, Pakistan

Naeem Mubarak,1 Fatima Rahman Rana,1 Taheer Zahid,2,* Umm-E-Barirah Ijaz,1,* Afshan Shabbir,1,* Ahtesham Ghulam Bari,1,* Bisma Niaz,1,* Sabba Kanwal,1 Nasira Saif-Ur-Rahman,3 Zahid Iqbal,1 Asad Majeed Khan,3 Che Suraya Zin,4 Khalid Mahmood,5 Mohamed Hassan Elnaem,6 Saba Tariq7 1Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Lahore University of Biological and Applied Sciences, Lahore, Pakistan; 2Pharmacy Manager, Servaid Pharmacy, 24-M Quaid-E-Azam Industrial Estate, Lahore, Punjab, Pakistan; 3Department of Pharmaceutics, Faculty of Pharmaceutical Sciences, Lahore University of Biological and Applied Sciences, Lahore, Pakistan; 4Department of Pharmacy Practice, Kulliyyah of Pharmacy, International Islamic University, Kuantan, Malaysia; 5Institute of Information Management, University of the Punjab, Lahore, Punjab, Pakistan; 6School of Pharmacy and Pharmaceutical Sciences, Ulster University, Coleraine, UK; 7Pharmacology and Therapeutics, University Medical & Dental College, the University of Faisalabad, University of Birmingham, Birmingham, UK*These authors contributed equally to this workCorrespondence: Saba Tariq, Department of Metabolism and Systems Sciences, School of Medical Sciences, College of Medicine and Health, University of Birmingham, B15 2TT, Birmingham, England, United Kingdom, Email [email protected] Naeem Mubarak, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Lahore University of Biological and Applied Sciences, Lahore, Punjab, 54000, Pakistan, Email [email protected]: The opioid crisis continues to be a public health concern worldwide due to the high rates of misuse and associated mortality. Opioid dispensing competencies are critical for pharmacy graduates to promote the rational use of opioids.Purpose: To evaluate the opioids dispensing competencies among the final year Pharm-D students in Punjab, Pakistan.Design: A multicenter cross-sectional study.Methods: A validated survey was used to evaluate 11 competencies related to opioid use from the final year Pharm-D students from diversely located accredited institutes. On a summative scale, correct response to each survey item was worth a score/point. Descriptive statistics was used for categorical variables while independent t-test computed group differences.Results: A total of n = 661 final year Pharm-D students from 28 institutes (8 public and 20 private) completed the survey with an overall response rate of 78.5%. Comparatively, the students who had either completed a community or hospital internship, or studying in the educational institutions located in the provincial capital demonstrated a significant higher competency score. There was no significant difference in the overall mean competency scores based on gender or system of assessment used in the Pharm-D degree programs. Among eleven opioid competencies, students received the lowest scores for “opioid overdose management”, “opioid monitoring” and “therapeutic uses of opioids”.Conclusion: Pharm-D students in Pakistan require additional training and skills on many of the opioids related competencies to ensure patient’s safety in healthcare settings. There is a need to revise the curriculum and teaching methodologies to improve the competencies of Pharm-D students in opioid dispensing.Plain Language Summary: The study was conducted to assess the opioids dispensing competencies of final-year Pharm-D students in Punjab, Pakistan. These competencies were identified in an Australian study which defined 11 consensus-based core competencies on opioid use and dispensing for pharmacist. Given the ongoing opioid crisis, it is crucial for future pharmacists to acquire the necessary knowledge, skills, and confidence to handle opioid prescriptions, provide patient education, and contribute to harm reduction efforts. The results of the study underscored the importance of continuous education and training for pharmacy students in opioid use and dispensing. Competency in this area is essential for reducing the risk of opioid misuse and overdose, ensuring safe and effective patient care, and supporting broader public health efforts to combat the opioid crisis. The findings suggest that among eleven opioid competencies, students received the lowest scores for “opioid overdose management”, “opioid monitoring” and “therapeutic uses of opioids”.This calls for the development of specialized training programs, policy changes, and enhanced support for pharmacy students in these areas as they prepare to navigate the complexities of opioid dispensing and patient safety in their future careers.Keywords: opioid use, opioid dispensing, opioid competency, pharmacy students, pharmacy education