Buprenorphine physician-pharmacist collaboration in the management of patients with opioid use disorder: Results from a multisite study of the National Drug Abuse Treatment Clinical Trials Network.
This is the primary outcomes article for CTN-0075.
Physician and pharmacist collaboration may help address the shortage of buprenorphine-waivered physicians and improve care for patients with opioid use disorder (OUD). This study, CTN-0075, investigated the feasibility and acceptability of a new collaborative care model involving buprenorphine-waivered physicians and community pharmacists.
The study was a nonrandomized, single-arm, open-label feasibility trial held in three office-based buprenorphine treatment (OBBT) clinics and three community pharmacies in the United States. Participants were six physicians, six pharmacists, and 71 patients aged 18 or older with DMS-5 OUD on buprenorphine maintenance. After screening, eligible patients’ buprenorphine care was transferred from their OBBT physician to a community pharmacist for 6 months. Primary outcomes included recruitment, treatment retention and adherence, and opioid use. Secondary outcomes were intervention fidelity, pharmacists’ use of prescription drug monitoring program (PDMP), participant safety, and satisfaction with treatment delivery.
A high proportion (93.4%) of eligible participants enrolled into the study. There were high rates of treatment retention (88.7%) and adherence (95.3%) at the end of the study. The proportion of opioid-positive urine drug screenings (UDSs) among complete cases (i.e., those with all six UDSs collected during 6 months) at month 6 was 4.9%. Intervention fidelity was excellent. Pharmacists used PDMP at 96.8% of visits, and there were no opioid-related safety events. Over 90% of patients endorsed that they were “very satisfied with their experience and the quality of treatment offered,” that “treatment transfer from physician’s office to the pharmacy was not difficult at all,” and that “holding buprenorphine visits at the same place the medication is dispensed was very or extremely useful/convenient.” Similarly, positive ratings of satisfaction were found among physicians/pharmacists.
Conclusions: Overall success of this pilot trial offers strong support for a physician-pharmacist collaborative care model to help improve buprenorphine treatment access for OUD. Future randomized trials are needed to test the efficacy, effectiveness, and implementation of physician-pharmacist collaborative care models for management and treatment of patients with OUD as part of real-world practice.
Related protocols: CTN-0075