Physician–pharmacist collaborative care model for buprenorphine-maintained opioid-dependent patients

• DOI: 10.1331/japha.2015.14177
• Publication Date: 2015-03-07T23:30:21Z
• Authors: Bethany A. DiPaula; Elizabeth Menachery
• Keywords: Adult; Male; Patient Care Team; Health Knowledge, Attitudes, Practice; Maryland; Attitude of Health Personnel; Medication Therapy Management; Naloxone; Narcotic Antagonists; Opioid-Related Disorders; Pharmacists; Buprenorphine; 3. Good health; Analgesics, Opioid; 03 medical and health sciences; Opiate Substitution Treatment; Humans; Patient Compliance; Female; Interdisciplinary Communication; Buprenorphine, Naloxone Drug Combination; Cooperative Behavior; 0305 other medical science

To develop a physician-pharmacist collaborative practice for opioid-dependent patients designed to increase access to treatment, optimize patient care, reduce cost, minimize physician burden, and prevent diversion.Suburban health department.Physician-pharmacist buprenorphine/naloxone maintenance practice.Traditionally, health department buprenorphine/naloxone patients have been referred to community physicians at considerable cost with varying outcomes. In this pilot project, patients were managed using a drug therapy management model. Intake assessments and follow-up appointments were conducted by the pharmacist. The pharmacist debriefed with the physician and documented each interaction, allowing for efficient assessment completion. The physician appended notes, when applicable, and cosigned each patient's record. The pharmacist prevented diversion by gathering data from outside providers, pharmacies, and laboratories.This health department program improved care by producing structure and expanding treatment options. A total of 12 patients completed full intakes with 135 follow-up appointments equating to an estimated savings of $22,000. The program demonstrated a 91% attendance rate, 100% 6-month retention rate, and 73% 12-month retention rate. Overall, 127 (98%) urine toxicology screens were positive for buprenorphine and 114 (88%) were positive for buprenorphine and negative for opioids.Physician and pharmacist collaboration optimized care of buprenorphine-maintained patients. Data from this pilot were used to develop a permanent physician-pharmacist program and to obtain approval for the first state-approved opioid use disorder drug therapy management protocol.