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

Area of Science:

• Pharmacology
• Public Health
• Addiction Medicine

Background:

• Opioid use disorder (OUD) presents significant public health challenges.
• Traditional referral models for OUD treatment can be costly and yield variable outcomes.
• Health departments often face limitations in providing direct OUD pharmacotherapy.

Purpose of the Study:

• To establish a physician-pharmacist collaborative practice for patients with opioid dependence.
• To enhance access to buprenorphine/naloxone treatment.
• To optimize patient care, reduce costs, and prevent diversion of medications.

Main Methods:

• Implemented a drug therapy management model within a suburban health department.
• Pharmacists conducted patient intake assessments and follow-up appointments.
• Physicians collaborated with pharmacists, reviewing and cosigning patient records.
• Pharmacists actively monitored for diversion by collecting data from external sources.

Main Results:

• The pilot program successfully managed 12 patients with 135 follow-up appointments.
• Achieved an estimated cost saving of $22,000.
• Demonstrated high patient engagement with a 91% attendance rate.
• Reported excellent patient retention: 100% at 6 months and 73% at 12 months.
• Urine toxicology screens confirmed high adherence to buprenorphine and absence of other opioids in most cases.

Conclusions:

• Physician-pharmacist collaboration effectively optimized care for buprenorphine-maintained patients.
• The pilot data supported the development of a permanent program and a state-approved OUD drug therapy management protocol.
• This collaborative model offers a scalable solution for improving OUD treatment delivery.