The opioid crisis is a pressing challenge in the United States; opioids, mainly fentanyl, were responsible for the majority of the 108,000 overdose deaths in 2022 (Volkow & Blanco, 2021; WHO,2025). To address these risks, the FDA approved the Extended-Release and Long-Acting (ER/LA) Opioid Analgesics Risk Evaluation and Mitigation Strategy (OA REMS) in 2012, mandating manufacturers to offer continuing education on opioid safety for healthcare professionals (HCPs) who prescribe these medications (U.S. Food and Drug Administration,2012).Since pharmacists are well versed in medication safety, they are uniquely positioned to lead and support interprofessional education (IPE) that strengthens opioid stewardship.

This article examines how pharmacist faculty involvement in REMS-related IPE influences learner knowledge, collaboration and identification of barriers to effective teamwork.

The Role of Pharmacists in Opioid Stewardship

Patterns of prescribing and using that do not have adequate safety supervision tend to promote opioid misuse, particularly in cases of medications that are prescribed without sufficient monitoring and safety controls (Volkow & Blanco, 2021). Pharmacists ensure safer opioid use by evaluating medications, encouraging safe prescribing, giving guidance to patients and collaborating with other HCPs to optimize therapy (Gondora et al., 2012). Within the OA REMS framework, these professionals take on educational leadership roles, sharing expertise with various HCPs.

Study Overview

Considering the increasing demand for efficient opioid safety training and the current opioid crisis, a retrospective study was performed to determine the effect of various educational staff on the knowledge acquisition and interprofessional cooperation. The research assesses the program effectiveness of continuing professional development programs within the OA REMS framework, namely comparing pharmacist involvement and no involvement sessions. Three continuing professional development (CPD) programs were analyzed. They were separated into two groups of learners, such as pharmacists, advanced practice nurses (APNs), physicians, and nurses:

• Pharmacist Faculty Group: IPE sessions included at least one pharmacist as faculty.
• Non-pharmacist Faculty Group: IPE sessions did not include pharmacists as faculty.

To be included, learners had to complete at least 75% of the pretest and posttest assessments and claim credit for the session. Knowledge improvement was measured using statistical testing (Welch’s t-test), and interprofessional collaboration was evaluated using the Mann-Whitney U test (McDonald, 2014).

Of the 1858 learners, 1657 (89%) participated in sessions led by pharmacist faculty, and 201 (11%) attended sessions without pharmacist faculty (Table 1).

Table 1. Learner Demographics

Group	Pharmacists  n (%)	APNs n (%)	Physicians n (%)	Nurses n (%)
Sessions Without Pharmacist Faculty Involvement	117(58%)	25(12%)	23(13%)	13(7%)
Sessions With Pharmacist Faculty Involvement	634(49%)	424(33%)	131(10%)	105(8%)

Presence of Pharmacists Increases Knowledge Gains

In sessions that included pharmacist faculty, learners recorded an average pretest score of 53%, which increased to 93% on the posttest. The overall improvement (Δ ± standard deviation) was 40.2 ± 25.3%. Conversely, sessions that excluded pharmacist faculty yielded a pretest mean score of 59%, which increased to 90% at posttest, thus indicating a mean improvement (Δ ± standard deviation) of 31.8 ± 23.1%. The difference in mean improvement between the two groups was statistically significant (P <.05).

Table 2. Interprofessional Collaboration Outcomes

Evaluation Outcomes	With Pharmacist Faculty	Without Pharmacist Faculty
Understanding Roles	1.48 ± 0.69 (95% CI: 1.45–1.49)	1.45 ± 0.59 (95% CI: 1.41–1.50)
Promoting Communication	1.48 ± 0.71 (95% CI: 1.44–1.48)	1.50 ± 0.59 (95% CI: 1.45–1.55)
Recognizing Contributions	1.46 ± 0.69 (95% CI: 1.42–1.47)	1.45 ± 0.59 (95% CI: 1.41–1.50)

To assess the effectiveness of the interventions, evaluation outcomes were measured using a Likert scale (1 = Strongly agree, 5 = Strongly disagree). Interestingly, results for sessions with and without pharmacist faculty involvement were not statistically significant (P > .05).

Identified Barriers

To have a better insight into the difficulties of opioid safety education, the research determined that there are several barriers that were reported by the study participants during the sessions:

• In the sessions with pharmacist faculty, the major barriers were peer acceptance (reported by 59% of pharmacists and 41% of APNs) and time constraints (46% of pharmacists, 43% of APNs).
• In sessions without the pharmacist faculty, the most common barriers reported were limited availability of therapies (30% of pharmacists, 26% of APNs) and cost restrictions (21% of pharmacists, 15% of APNs).

What This Means for IPE

The retrospective analysis resulted in a similar outcome between the two groups. Interpersonal and structural challenges were also diagnosed during the sessions with pharmacist faculty, including peer acceptance and time constraints. Conversely, meetings that lacked pharmacist faculty more often identified limitations within the systemic resources such as cost constraints and the availability of therapy.

To address identified challenges to opioid safety training, education should prioritize overcoming lack of peer acceptance and of increasing role clarity by implementing structured peer-learning, role discussions and targeted faculty training. Education should include blended asynchronous and live learning formats to address time constraints. 

Involving Pharmacists: An Approach Consistent with the Broader Body of Literature

Gondora et al. showed that pharmacists play a central role in opioid stewardship by promoting safe prescribing and strengthening team performance (Gondora et al., 2022). Conversely, Chen et al. examined pharmacist-led opioid stewardship programs that improved opioid safety and prescribing optimization; (Chen et al.,2021) however, this study did not observe measurable differences in collaboration between groups. This difference implies that the educational setting, not merely the involvement of pharmacists, may be a key factor influencing collaborative outcomes.

Call to Action

Program planners and stakeholders need to include pharmacists as faculty to collaborate and proactively dismantle interprofessional barriers. Knowledge outcomes, team-based practice, and ultimately advanced opioid stewardship will be improved.

References

Chen, A., Legal, M., Shalansky, S., Mihic, T., & Su, V. (2021). Evaluating a Pharmacist-Led Opioid Stewardship Initiative at an Urban Teaching Hospital. Canadian Journal of Hospital Pharmacy, 74(3). https://doi.org/10.4212/cjhp.v74i3.3152

Gondora, N., Versteeg, S. G., Carter, C., Bishop, L. D., Sproule, B., Turcotte, D., Halpape, K.,Beazely, M. A., Dattani, S., Kwong, M., Nissen, L., & Chang, F. (2022). The role of pharmacists in opioid stewardship: A scoping review. Research in Social & Administrative Pharmacy: RSAP, 18(5), 2714–2747. https://doi.org/10.1016/j.sapharm.2021.06.018

McDonald, J. H. (2014). Handbook of biological statistics (3rd ed.). Sparky House Publishing. https://www.biostathandbook.com

Opioid overdose. (n.d.). Retrieved November 3, 2025, from https://www.who.int/news-room/fact-sheets/detail/opioid-overdose

Research, C. for D. E. and. (2019). Questions and Answers: FDA approves a Risk Evaluation and Mitigation Strategy (REMS) for Extended-Release and Long-Acting (ER/LA) Opioid Analgesics. FDA. https://www.fda.gov/drugs/information-drug-class/questions-and-answers-fda-approves-risk-evaluation-and-mitigation-strategy-rems-extended-release-and

Volkow, N. D., & Blanco, C. (2021). The changing opioid crisis: development, challenges and opportunities. Molecular Psychiatry, 26(1), 218–233. https://doi.org/10.1038/s41380-020-0661-4

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Disclosures

Conflict of Interest Statement

The authors have no conflict of interest. As all authors are pharmacists, the viewpoints presented reflect this professional background. The findings, however, are based on objective program evaluation data and not opinion.

Acknowledgments

Generative AI (ChatGPT) produced rough drafts for two tables. Each AI-produced table was subjected to a thorough human review for precision and completeness, and all usage was in accordance with the Alliance AI Position Statement, which includes privacy protection, bias mitigation and regulatory compliance.

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Leen Alyaseen, MBA, PharmD, is a second-year healthcare education and outcomes research fellow at the Decera Clinical Education.
Lisa Phipps, PharmD, PhD, is a director of scientific services, neuroscience at the Decera Clinical Education.
Logan Van Ravenswaay, PharmD, is a scientific director, multispecialty at the Decera Clinical Education.
Sarah A. Nisly, PharmD, MEd, BCPS, FCCP, is a senior vice president, outcomes and insights at the Decera Clinical Education.