Leveraging pharmacists to maintain and extend buprenorphine supply for opioid use disorder amid COVID-19 pandemic

Peckham, Alyssa M.; Ball, Jennifer; Colvard, Michelle; Dadiomov, David; Hill, Lucas G.; Nichols, Stephanie D.; Tallian, Kimberly; Ventricelli, Daniel; Tran, Tran H.

doi:10.1093/ajhp/zxab003

Cited by 25 publications

(28 citation statements)

References 28 publications

(9 reference statements)

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“…Throughout our study, pharmacists highlighted their role in clinically assessing patients for OAT, especially during the pandemic when both patients and pharmacists had challenges in accessing prescribers. Others have also advocated for the expanded role of pharmacists given their clinical expertise, accessibility, and ability to develop longitudinal relationships with their patients ( Cochran et al, 2020 , Green et al, 2020 , Peckham et al, 2021 ; Z. R. Rosenberg-Yunger et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

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Pharmacists expanded role in providing care for opioid use disorder during COVID-19: A qualitative study exploring pharmacists’ experiences

Bishop

Rosenberg‐Yunger

2022

Drug and Alcohol Dependence

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Introduction During the COVID-19 pandemic, patients with opioid use disorder (OUD) struggled with access to prescribers and opioid agonist therapy (OAT). Recognizing this gap in care, Health Canada issued a short-term subsection 56(1) class exemption from the Controlled Drugs and Substances Act authorizing pharmacists to independently manage controlled substances. The purpose of this study was to explore the expanded role of Canadian pharmacists in providing care to patients with OUD during the pandemic. Methods We conducted qualitative key informant telephone interviews in the fall of 2020 with Canadian pharmacists who used the exemption. We included community or primary healthcare team-based pharmacists who managed opioid medication under the exemption. We recorded, transcribed verbatim, and de-identified all transcripts. Data was analyzed using a thematic approach involving line-by-line coding and constant comparison. Results We interviewed nineteen pharmacists with representation from all provinces and urban and rural practice settings. Three major themes emerged that captured the pharmacists’ perspectives when providing care for patients with OUD during the pandemic: (i) continuity of care; (ii) harm reduction; and (iii) access to care. Pharmacists used the exemption to extend prescriptions, transfer prescriptions, receive verbal orders, and deliver OAT. Conclusions Throughout the pandemic, pharmacists were able to provide continuity of care to patients with OUD who would have otherwise been unable to access care. The exemption permitted pharmacists to assess patients and provide OAT through this expanded role. Other countries should look to the Canadian experience and leverage the expertise of the pharmacist to expand their scope so that they can help fill the gap in care for patients with OUD.

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Section: Discussionmentioning

confidence: 99%

“…Peckham et.al. also noted the impact of the pandemic on reducing access to OAT and suggested leveraging pharmacists’ role to help improve access ( Peckham et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Pharmacists expanded role in providing care for opioid use disorder during COVID-19: A qualitative study exploring pharmacists’ experiences

Bishop

Rosenberg‐Yunger

2022

Drug and Alcohol Dependence

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“…However, the pandemic reduced access to medication for opioid addiction (buprenorphine, methadone, etc.). Thus, pharmacists are qualified and capable to ensure the continuity of treatment, and they could be used to facilitate access to drugs [ 36 ].…”

Section: The Impact Of the Authorities’ Decisions On Pharmaceutical Carementioning

confidence: 99%

The Particularities of Pharmaceutical Care in Improving Public Health Service during the COVID-19 Pandemic

Ghibu

Juncan

Rus

et al. 2021

IJERPH

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Nowadays, humanity is confronted with one of the most difficult challenges. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was identified for the first time in Hubei, China in December 2019 and produced the COVID-19 pandemic, a devastating disease that led to many complications and deaths. The authorities and the global healthcare system have been alerted regarding the prevention and treatment of this pathology. Even though worldwide quarantine was declared, health care professionals, including pharmacists, have been at the frontline in this war. Since the beginning of the pandemic, the authorities relied on the involvement of the community, hospital, or clinical pharmacists in offering support to the entire population. Also, the authorities implemented measures for emergency authorization of the vaccines, or the drugs used in COVID-19 treatment. In order to facilitate the population’s access to healthcare services, the authorities have established regulations regarding, the extension of prescriptions by pharmacists, working hours, prevention of shortages and price-increase, drive-thru services, etc. However, several countries have taken financial measures to support the pharmacies’ activity. At the same time, pharmaceutical associations elaborated guidelines for the protection of pharmacists and patients alike. Additionally, the pharmacies have come to support the health system and patients by adapting pharmaceutical care to the new needs like preparation and supply of disinfectants, patient care, information, and counseling, especially to COVID-19 patients, as well as the implementation of home drugs-delivery systems. The important roles played by pharmacists were to perform COVID-19 tests and further vaccines, as well as to combat the abundance of misinformation and fake news. The clinical and hospital pharmacy services have also been adapted. Strengthening the role of the pharmacist in the medical team was important for the purpose of providing correct and complete information regarding drugs used in the COVID-19 pathology. In all these activities, pharmacists needed creativity and professionalism, but also the support of pharmacy owners and managers. With this crisis, pharmaceutical care has entered a new phase, demonstrating the ability of pharmacists to be competent and accessible providers of public health. Based on this information, we conducted a narrative review whose purpose was to identify the impact of the authorities’ decisions on pharmaceutical practice, the involvement of professional associations, and the responsibilities of the pharmacy owners and management. On the other hand, we performed a global assessment on the pharmaceutical care services provided by community pharmacists as well as by clinical or hospital pharmacists during the COVID-19 pandemic.

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“…Besides its direct impact on public health in the US, the COVID-19 pandemic also has had many subtle and less direct effects. For example, many people with non-COVID health issues have encountered difficulties in obtaining appropriate care for their non-COVID problems, as national health leaders called for hospitals to forgo routine visits as well as screening and elective procedures (Puntillo et al, 2020;Caton et al, 2021;Jacka et al, 2021;Kedia et al, 2021;Linas et al, 2021;Mun et al, 2021;Peckham et al, 2021). The lack of access to care has been especially acute for patients with chronic pain problems and/ or substance use disorders (Jacka et al, 2021;Kedia et al, 2021;Narayan and Balkrishnan, 2021).…”

Section: Impact Of the Covid-19 Pandemic On Supply And Demand For Kratommentioning

confidence: 99%

Kratom Use Within the Context of the Evolving Opioid Crisis and the COVID-19 Pandemic in the United States

Prozialeck

Lamar

Krupp³

et al. 2021

Front. Pharmacol.

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Kratom (Mitragyna speciosa, Korth.) is an evergreen tree that is indigenous to Southeast Asia. When ingested, kratom leaves or decoctions from the leaves have been reported to produce complex stimulant and opioid-like effects. For generations, native populations in Southeast Asia have used kratom products to stave off fatigue, improve mood, alleviate pain and manage symptoms of opioid withdrawal. Despite the long history of kratom use in Asia, it is only within the past 10–20 years that kratom has emerged as an important herbal agent in the United States, where it is being used for the self-treatment of pain, opioid withdrawal symptoms, and mood disorders. The increase in the use of kratom in the United States has coincided with the serious epidemic of opioid abuse and dependence. Since 2015, efforts to restrict access to prescription opioids have resulted in a marked increase in the use of “street” opioids such as heroin and illicit fentanyl. At the same time, many patients with chronic pain conditions or opioid use disorder have been denied access to appropriate medical help. The lack of access to care for patients with chronic pain and opioid use disorder has been magnified by the emergence of the COVID-19 pandemic. In this report, we highlight how these converging factors have led to a surge in interest in kratom as a potential harm reduction agent in the treatment of pain and opioid use disorder.

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Leveraging pharmacists to maintain and extend buprenorphine supply for opioid use disorder amid COVID-19 pandemic

Cited by 25 publications

References 28 publications

Pharmacists expanded role in providing care for opioid use disorder during COVID-19: A qualitative study exploring pharmacists’ experiences

Pharmacists expanded role in providing care for opioid use disorder during COVID-19: A qualitative study exploring pharmacists’ experiences

The Particularities of Pharmaceutical Care in Improving Public Health Service during the COVID-19 Pandemic

Kratom Use Within the Context of the Evolving Opioid Crisis and the COVID-19 Pandemic in the United States

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