TY - JOUR
T1 - Physician-pharmacist collaborative care model for buprenorphine-maintained opioid-dependent patients
AU - DiPaula, Bethany A.
AU - Menachery, Elizabeth
N1 - Publisher Copyright:
© 2015, American Pharmacists Association. All rights reserved.
PY - 2015/3/1
Y1 - 2015/3/1
N2 - Objectives: 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. Setting: Suburban health department. Practice description: Physician-pharmacist buprenorphine/naloxone maintenance practice. Practice innovation: 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. Results: 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. Conclusion: Physician and pharmacist collaboration optimized care of bu-prenorphine- 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.
AB - Objectives: 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. Setting: Suburban health department. Practice description: Physician-pharmacist buprenorphine/naloxone maintenance practice. Practice innovation: 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. Results: 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. Conclusion: Physician and pharmacist collaboration optimized care of bu-prenorphine- 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.
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U2 - 10.1331/JAPhA.2015.14177
DO - 10.1331/JAPhA.2015.14177
M3 - Article
C2 - 25749264
AN - SCOPUS:84924350470
SN - 1544-3191
VL - 55
SP - 187
EP - 192
JO - Journal of the American Pharmacists Association
JF - Journal of the American Pharmacists Association
IS - 2
ER -