Pharmacist Inclusion in OUD Treatment Teams Benefits Patients

Originally published by our sister publication Specialty Pharmacy Continuum

By Myles Starr

Incorporating pharmacists into opioid use disorder (OUD) treatment improves patient outcomes and boosts efficiency in the healthcare system, according to data presented at ASHP Pharmacy Futures 2024, in Portland, Ore. 

A case study of the clinical pharmacist practitioner (CPP) Veteran Access Initiative for Substance Use Disorder (CRVA-SUD) program demonstrates how training pharmacists to be integrated into OUD treatment teams increased access to care and improved treatment retention.

“In the CRVA-SUD, after an OUD diagnosis is made by a provider, … anyone who has prescribing privileges, including the clinical pharmacist practitioner, can then pick up the initiation, stabilization and maintenance phases of care,” explained Terri L. Jorgenson, RPh, BCPS, the national program manager of clinical practice integration and model advancement at the VA Pharmacy Benefits Management Clinical Pharmacy Practice Office, in Maryland. “This means pharmacists can manage patients independently—yet still collaboratively—with the team.”

Therefore, pharmacists, who are often points of contact with whom patients are comfortable, can prescribe medications for OUD (MOUD) without a patient needing to see a physician again. Furthermore, in rural areas where providers are limited, pharmacists can improve access to MOUD when reaching a doctor would be difficult. Both of these factors, according to Ms. Jorgenson, improve patient satisfaction and promote treatment retention. 

As of June, 142 pharmacists had gone through the entire CRVA-SUD program and prescribed buprenorphine for OUD treatment in 66 Veterans Affairs facilities for 1,700 patients.

Support and training were among the keys to the program’s success, not only for the pharmacists involved but for the nurses and doctors with whom they collaborated. The program included:

• clinical training in SUD care for CPPs;
• routine accountable partnerships with stakeholders (including launch meetings, interdisciplinary visits with challenged sites and facility implementation calls);
• consultative visit evolution with multiple disciplines; and
• quantitative and qualitative evaluation and multilevel marketing of the program.

Between 2020 and 2023, CCPs in the program had more than 39,000 encounters with veterans, 21% of whom had an OUD diagnosis, with improved provider and patient satisfaction levels.

Not Just a VA Success

Incorporating pharmacists into OUD treatment has also worked outside the VA. In a 2014 study cited in the presentation, six pharmacists from three community pharmacies were paired with three office-based buprenorphine clinics and six physicians. In this study, after physicians made an OUD diagnosis, pharmacists did all the follow-up care. “There were some very impressive results, including zero overdoses in this population,” Ms. Jorgenson said. “Among the 71 patients enrolled, there was an 88.7% treatment retention rate at six months, a 95.3% visit adherence rate and a 100% medication adherence rate with very high satisfaction rates across [all providers] and patients.”

Whether in the VA or on a state level, the presentation made clear that role clarity is key to success for interdisciplinary teams treating patients with OUD, Ms. Jorgenson stressed. “Everybody needs to be involved in the conversation to understand each other’s roles so you can take the best care of patients and figure out who needs to jump in,” she said. “This is how a collaborative care model can exist effectively for the patient.”

Dr. Jorgenson reported no relevant financial disclosures.