A physician-pharmacist collaborative care model to prevent opioid misuse.

Area of Science:

• Pharmacology
• Pain Management
• Primary Care

Background:

• Clinical pharmacists can extend chronic pain and opioid prescription management in primary care.
• A collaborative care model involving pharmacists and physicians was explored for chronic pain patients.

Purpose of the Study:

• To evaluate the feasibility and acceptability of a pharmacist-physician collaborative care model for patients with chronic pain.
• To assess the potential of clinical pharmacists in managing chronic pain and opioid prescriptions.

Main Methods:

• A 4-month pharmacist consultation program in two primary care practices.
• Included patient surveys, electronic medical record (EMR) review, and provider interviews.
• Pharmacist recommendations communicated to primary care physicians (PCPs) via EMR and direct communication.

Main Results:

• 47 of 182 eligible patients enrolled; 46 completed follow-up.
• Pharmacist recommended non-opioid switch (30 patients), buprenorphine (20 patients), or opioid taper (3 patients).
• Physicians found the model acceptable but desired more guidance on buprenorphine prescribing; patients reported varied physician follow-up.

Conclusions:

• Pharmacist-physician comanagement of chronic pain is feasible and acceptable.
• Policy changes to expand pharmacist prescribing authority could improve opioid tapering and buprenorphine use for pain.
• Enhanced pharmacist roles may improve chronic pain management and opioid stewardship.