First insights into community pharmacy based buprenorphine-naloxone dispensing in Finland

Uosukainen, Hanna; Bell, Jane; Laitinen, Kirsti; Tacke, Ulrich; Ilomäki, Jenni; Turunen, Juha

doi:10.1016/j.drugpo.2013.02.004

Cited by 10 publications

(10 citation statements)

References 24 publications

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“…Indiana community pharmacist preceptors' knowledge SCIENCE AND PRACTICE S21 Finland, a study evaluated community-based pharmacist dispensing practices, service experiences, and problems in dispensing and supervising buprenorphine-naloxone directly to patients. 17 Researchers found high pharmacist satisfaction in dispensing and a perceived need to improve this service.…”

Section: Resultsmentioning

confidence: 99%

“…12 Given that MAT roles have expanded internationally, there is extensive research evaluating community-based pharmacists' roles and perceptions regarding MAT outside the United States. [12][13][14][15][16][17] Nielsen et al 12 found that Australian pharmacists believed that considerable buprenorphine diversion occurred. 12 Lawrinson et al 13 also surveyed Australian pharmacists and identified that most held positive MAT perceptions (methadone, buprenorphine) and believed that patients derived benefit, but there were concerns regarding diversion.…”

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confidence: 99%

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Indiana community pharmacist preceptors’ knowledge and perceptions of medication-assisted treatment

Davenport¹,

Arnett²,

Nichols³

et al. 2020

Journal of the American Pharmacists Association

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Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

Indiana community pharmacist preceptors’ knowledge and perceptions of medication-assisted treatment

Davenport¹,

Arnett²,

Nichols³

et al. 2020

Journal of the American Pharmacists Association

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“…Because of the emergence of widespread IV BUP abuse, BUP was restricted for treatment during pregnancy only, and BUP/NX, introduced in 2006, became the more commonly prescribed formulation. Notably, BUP and BUP/NX treatment have stringent criteria for treatment entry that begins in specialty addiction treatment clinics where dosing is observed (Forsell et al, 2010; Uosukainen et al, 2013a). …”

Section: Epidemiology Of Buprenorphine Diversion and Misusementioning

confidence: 99%

A Review of Buprenorphine Diversion and Misuse

Lofwall

Walsh

2014

Journal of Addiction Medicine

208

109

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Outpatient opioid addiction treatment with sublingual buprenorphine pharmacotherapy (OBOT) has rapidly expanded in the United States and abroad, and, with this increase in medication availability, there have been increasing concerns about its diversion, misuse and related harms. This narrative review defines the behaviors of diversion and misuse, examines how the pharmacology of buprenorphine alone and in combination with naloxone influence its abuse liability, and describes the epidemiological data on buprenorphine diversion and intravenous misuse, risk factors for its intravenous misuse and the unintended consequences of misuse and diversion. Physician practices to prevent, screen for, and therapeutically respond to these behaviors, which are a form of medication non-adherence, are discussed and gaps in knowledge are identified. OBOT experiences from other countries that have varied health care systems, public policies, and access to addiction treatment are shared in order to make clear that diversion and misuse occur across the world in various contexts, for many different reasons, and are not limited to buprenorphine. Comparisons are made with other opioids with known abuse liability as well as medications with no known abuse. The objective is to facilitate understanding of diversion and misuse so that all factors influencing their expression (patient and provider characteristics and public policy) can be appreciated within a framework that also recognizes the benefits of addiction treatment. With this comprehensive perspective, further careful work can help determine how to minimize these behaviors without eroding the current benefits realized through improved addiction treatment access and expansion.

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“…This is not unique to the UK; research conducted in Finland has also found that pharmacies must be adequately reimbursed for providing a service if the service is going to be successful long term [5]. This study suggests that the assumptions used to calculate the funding envelope for the NMS are flawed as the actually opportunity rate to provide the service is less than the theoretical rate that underpins the potential funding available.…”

Section: Discussionmentioning

confidence: 99%

“…Research conducted in the UK and Finland has found that adequate remuneration is an important facilitator to service provision and where payment is seen as inadequate, it can inhibit the uptake of services [2-5]. The payment structure for the NMS has been identified as a potential barrier to implementation [6].…”

Section: Introductionmentioning

confidence: 99%

What proportion of prescription items dispensed in community pharmacies are eligible for the New Medicine Service?

Wells

Boyd

Thornley

et al. 2014

BMC Health Serv Res

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BackgroundThe payment structure for the New Medicine Service (NMS) in England is based on the assumption that 0.5% of prescription items dispensed in community pharmacies are eligible for the service. This assumption is based on a theoretical calculation. This study aimed to find out the actual proportion of prescription items eligible for the NMS dispensed in community pharmacies in order to compare this with the theoretical assumption. The study also aimed to investigate whether the proportion of prescription items eligible for the NMS is affected by pharmacies’ proximity to GP practices.MethodsThe study collected data from eight pharmacies in Nottingham belonging to the same large chain of pharmacies. Pharmacies were grouped by distance from the nearest GP practice and sampled to reflect the distribution by distance of all pharmacies in Nottingham. Data on one thousand consecutive prescription items were collected from each pharmacy and the number of NMS eligible items recorded. All NHS prescriptions were included in the sample. Data were analysed and proportions calculated with 95% confidence intervals used to compare the study results against the theoretical figure of 0.5% of prescription items being eligible for the NMS.ResultsA total of 8005 prescription items were collected (a minimum of 1000 items per pharmacy) of which 17 items were eligible to receive the service. The study found that 0.25% (95% confidence intervals: 0.14% to 0.36%) of prescription items were eligible for the NMS which differs significantly from the theoretical assumption of 0.5%. The opportunity rate for the service was lower, 0.21% (95% confidence intervals: 0.10% to 0.32%) of items, as some items eligible for the NMS did not translate into opportunities to offer the service. Of all the prescription items collected in the pharmacies, 28% were collected by patient representatives.ConclusionsThe results of this study show that the proportion of items eligible for the NMS dispensed in community pharmacies is lower than the Department of Health assumption of 0.5%. This study did not find a significant difference in the rate of NMS opportunities between pharmacies located close to GP practices compared to those further away.

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First insights into community pharmacy based buprenorphine-naloxone dispensing in Finland

Cited by 10 publications

References 24 publications

Indiana community pharmacist preceptors’ knowledge and perceptions of medication-assisted treatment

Indiana community pharmacist preceptors’ knowledge and perceptions of medication-assisted treatment

A Review of Buprenorphine Diversion and Misuse

What proportion of prescription items dispensed in community pharmacies are eligible for the New Medicine Service?

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