AIMS: Scaling up opioid stewardship interventions without compromising their effectiveness is complex and requires careful consideration. Furthermore, scaling up within resource-constrained rural and remote hospitals is even more complex given the additional challenges of geographical isolation, transient workforce, and population-specific needs. This multi-method study assessed the potential scalability of the Opioid Stewardship Framework across Queensland, Australia, addressing risks associated with hospital-initiated opioid use and post-discharge harms. METHODS: The Intervention Scalability Assessment Tool (ISAT) was used to guide the scalability assessment. A variety of approaches was used, including a document review, an online survey, qualitative interviews, and a focus group. The assessment process sought to identify factors influencing the likelihood of successful scale-up. RESULTS: Ten participants from six hospitals across urban, regional, remote, and rural localities took part. This included pharmacists, medical staff, and people in clinical and senior management roles. The participants rated the importance of the problem and the effectiveness of the Framework highly, while infrastructure and cost considerations received lower ratings. The lower ratings in some domains reflected concerns that dedicated support was essential for successful implementation, particularly in rural/remote settings. CONCLUSION: The Framework shows promise for scale-up in remote and rural settings, as it aligns with the broader strategic and political context of opioid safety. However, the moderate to low scores across several implementation and resource-related domains highlight a range of potential issues that would need to be addressed prior to scale-up, including specific allocation for dedicated implementation support. SPANISH ABSTRACT: http://links.lww.com/IJEBH/A660.
Pattullo et al. (Wed,) studied this question.