Pharmacist‐delivered comprehensive medication management in a substance use disorder clinic, an 18‐month descriptive study

Abstract

Introduction Pharmacists have expanded their roles within interprofessional teams in substance use disorder (SUD) care, but data characterizing pharmacist‐delivered comprehensive medication management (CMM) in outpatient SUD treatment are limited. Objectives The purpose of this study was to characterize the patient population, and medication therapy problems (MTPs), and describe considerations for CMM development and implementation in an outpatient SUD treatment setting. Methods An observational, prospective, descriptive study was conducted in an outpatient SUD center. A clinical pharmacist provided CMM services to referred clients and documented data elements after each visit. The pharmacist comprehensively assessed clients' complete regimens to optimize medication use through collaboration with the clients and other healthcare providers. A post‐CMM electronic survey was sent to the clients' care teams to assess their attitudes and collect feedback regarding the collaboration process. Descriptive statistics were employed to describe the population, CMM services, MTPs, and survey responses. Results From April 1, 2021, to September 30, 2022, a total of 187 CMM encounters were delivered to a total of 112 clients with SUD. Nearly all patients (99%) had opioid use disorder as their primary diagnosis and the vast majority (95%) were receiving methadone treatment. Clients’ mean age was 39‐years‐old with an average of eight medications and six medical conditions. Of 201 MTPs identified, 54 MTPs (27%) were marked as “resolved” at follow‐up visits. The most commonly identified MTP category was the need for additional drug therapy (31%). The care team survey showed 100% agreed or strongly agreed that the CMM consult was helpful to the clients and the care team members. Conclusion Pharmacist‐delivered CMM in a SUD treatment setting was feasible and well perceived by care team members as helpful to bridge existing gaps in access to biomedical care, medication optimization, and medication use care coordination.

Pharmacist-prescriber collaborative models of care for opioid use disorder: an overview of recent research

“…The literature search identified eight collaborative models with outcome data and one trial protocol published within the past 3 years (three within the past 12 months) [29 ▪▪ ,30 ▪▪ ,31 ▪▪ ,32 ▪ ,33 ▪▪ ,34,35 ▪▪ ,36,37 ▪ ], as well as a smaller number of collaborative models published before 2021 [38–41]. These earlier models are not discussed in detail in the following sections, but have been included to ensure an accurate overview of pharmacist responsibilities within collaborative models has been provided.…”

“…Greater pharmacist involvement has typically led to improved outcomes (in relation to retention, relapse rates, and identification and management of medication adherence issues) or unchanged (in relation to opioid-related safety events and patient health and wellbeing), suggesting collaborative models offer an equivalent or greater standard of patient care [42 & ]. Although only a small number of published evaluations are available, these have generally found collaborative models to be feasible, with high satisfaction among patients, pharmacists, and prescribers [36,39,40,48].…”