41.3

0.3

11.7

68.8

2.5 3.9

36.1

7.3

27.7

84.8

67.5

38.6

60.0

45.5

55.1

0.7

17.1

78.0

6.7 7.8

57.7

10.1

55.9

86.382.3

63.4

74.167.8

1 2 3 4 5 6 7 8 9 10 11 12 13 14

Pre Post

* * * * * * * * *

*= p-value <0.05

Assessing change in Opioid Overdose Knowledge Scale (OOKS), Opioid Overdose Attitudes Scale (OOAS)

and Drugs and Drug Problems Perceptions Questionnaire (DDPPQ) scores amongst

multidisciplinary healthcare students at two academic institutionsMorgan L. Karrels, PharmD Candidate 20201; Amanda L. Colistro, PharmD Candidate 20201; Alyssa M. Peckham, PharmD, BCPP1

1College of Pharmacy-Glendale, Midwestern University, Glendale, AZ

Award Finalist Grant Funding Other Financial Support

CPNP Foundation

Strategic Goals Award

Morgan L. Karrels

CPNP Foundation Defining the

Future Research Grant

Awarded to Amanda L. Colistro

Midwestern University Office of Research &

Sponsored Programs Student Travel Grant

Awarded to Morgan L. Karrels

Background

• In 2017, the opioid epidemic was declared a “public health emergency” prompting the

release of a 5-point strategy to combat the opioid crisis

• This strategy identified healthcare providers as key players to prevent, detect, and

mitigate future opioid abuse and misuse

• Formal opioid epidemic didactic education is absent at both Midwestern University

campuses in Glendale, AZ and Downers Grove, IL; though education about opioids

and risk of addiction is present throughout

• Education specific to the opioid epidemic is essential for healthcare students to learn

prior to entering the workplace

Objective

• To assess the change in multidisciplinary healthcare student knowledge, attitude, and

perceptions related to the opioid epidemic at two academic institutions via OOKS,

OOAS, and DDPPQ.

Methods

• Two campus-wide mandatory courses were used to administer the surveys to all first-

year students enrolled in the Interprofessional One Health courses

• Survey responses were anonymous, responses were not matched

• Dichotomous variables analyzed using Pearson’s chi-square or Fisher’s exact test

• Continuous variables analyzed using Mann Whitney U

• Logistic regression analysis was performed for select DDPPQ questions.

• p-value < 0.05 determined statistical significance. SPSS Version 25 (IBM SPSS

Statistics, Armonk, NY) was used for all statistical analysis.

Week 1• Students were electronically administered the

demographic questionnaire, OOKS, OOAS, and DDPPQ

Week 2• Students viewed a 60-minute educational webinar about

the opioid epidemic, opioid overdose, naloxone use, and mitigation strategies for healthcare professionals

Week 6• Students were electronically re-administered the

demographic questionnaire, OOKS, OOAS, and DDPPQ

Opioid Overdose Knowledge Scale

(OOKS)

Opioid Overdose Attitude Scale

(OOAS)

Drug and Drug Problems

Perceptions Questionnaire

(DDPPQ)

Figure 3. Changes in OOKS for Entire Sample Population (% answered correctly)

OOKS

Of an estimated 2,169 students, we received 912 pre-assessment responses.

Downer’s Grove represented ~66%.

Of the 912 responses, we received 615 post-assessment responses (67% response rate)

Downer’s Grove represented ~76%.

Both assessments were dominated by Osteopathic, Pharmacy, and Dental students

(79% of pre- and 83% of post-assessment)

OOAS

% Agree12%

% Disagree88%

% Agree29%

% Disagree71%

I have enough information about how to manage an overdose

% Agree % Disagree

p-value <0.001

% Agree33%

% Disagree67%

% Agree57%

% Disagree43%

If someone overdoses, I would know what to do to help them

% Agree % Disagree

p-value <0.001

Figure 5. Changes in % Agree vs. % Disagree for Pharmacy Students Only

Figure 4. Questions with Most Significant Improvement (Change in % Agree)

Of the 28 questions asked, 16 displayed significant improvement

• 11 of the remaining 12 showed adequate performance

One question that collectively did not improve

• Ability to perform mouth-to-mouth resuscitation

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Pre Post

Downer'sGrove

Glendale

Optometry

OsteopathicMedicine

Dental

Pharmacy

Health Sciences

VeterinaryMedicine

19.6

-19.5

28

-31.3

20.2

-35

-25

-15

-5

5

15

25

• Attitude improvement on positively worded questions:

• I am already able to inject naloxone to someone who has overdosed

• During overdose, I know what to do

• I would be able to deal effectively with an overdose

• Attitude improvement on negative worded questions:

• I am going to need more training before I would feel confident helping someone who had overdosed

• I know very little about how to help someone who has overdosed

Overall, students felt more prepared to handle an overdose situation, and became more in favor of “Good Samaritan” naloxone use

When separated by college, pharmacy students showed the most improvement in attitudes

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

I know enough about thephysical effects of drug use to

carry out my role when workingwith drug users.

I know enough about the factorswhich put people at risk of

developing drug problems tocarry out my role when working

with drug users.

I know how to counsel drugusers over the long term.

I could easily find someone withwhom I could discuss any

personal difficulties with drugusers

Pre Post

Figure 6. DPPQ Questions with Most Significant Improvement, Pharmacy

DDPPQ

• 75% improvement observed in students’ perception of working with/treating

patients with opioid use disorder, specifically a better understanding of their

role and ability to counsel

• Again, pharmacy students showed the most significant change from baseline

Pharmacy students were 2 times more likely to feel they can appropriately counsel their

patients; however, other students were 1.5 times more likely to initiate the conversation

I feel I can appropriately advise

patients about opioids and their effects

OR 95% CI

Pharmacy students

vs. other students2.19 1.71 – 2.80

I feel I have the right of ask patients

about their opioid use when necessary

OR 95% CI

Pharmacy students

vs. other students0.65 0.50 – 0.84

Table 1. Logistic Regression Analyses of Pharmacy Students on select DDPPQ

Figure 1. Participants by Campus Figure 2. Participants by College

Significant Improvement

• 11 out of 14 questions displayed statistically significant improvement

Significant Improvement, Poor Performance

• #3: manage an overdose

• #5: routes of naloxone administration

• #6: site of non-expert naloxone administration

No Significant Improvement

• #2: ability to identify symptoms of an overdose

• #8: naloxone duration of action

• #10: need to call an ambulance

Demographic Information

Results

* *

Summative Interpretation

Table 2. Summary of Each Assessment by Overall Sample, Campus, & College

OOKS OOAS DDPPQ

Sample Overall improvement Overall improvement Overall improvement

CampusSimilar overall

improvementGlendale > Downers Grove Glendale > Downers Grove

College

Osteopathic, Pharmacy,

and Dental significantly

improved

Osteopathic Medicine and

Pharmacy significantly

improved

Osteopathic Medicine,

Optometry, and Pharmacy

significantly improved

Conclusion• In the absence of targeted education, multidisciplinary healthcare students have less knowledge, poorer attitudes, and negative perceptions about opioids, opioid use disorder, naloxone use, and mitigation strategies• Incorporating opioid epidemic/overdose & naloxone use education into the curriculum of all healthcare professionals enhanced knowledge and shifted attitudes/perceptions to be more positive for some students only• It is anticipated that improvement in knowledge, attitudes, and perceptions will lead to better outcomes in our ongoing battle to combat the opioid epidemic; though tailored education is required for some disciplines