Community pharmacy-based injectable naltrexone service delivery models and best practices

Area of Science:

• Pharmacology
• Public Health
• Implementation Science

Background:

• Opioid use disorder (OUD) is a significant public health crisis in the US.
• Medications for OUD (MOUD) are effective but face supply and demand challenges.
• Injectable naltrexone is an approved MOUD, and pharmacists offer accessible administration.

Purpose of the Study:

• To explore how community pharmacists deliver injectable naltrexone treatment.
• To identify best practices for pharmacy-based naltrexone injection services.

Main Methods:

• Exploratory sequential mixed-methods design.
• Pharmacist questionnaires and interviews with pharmacists, prescribers, and stakeholders.
• Inductive content analysis to develop conceptual categories and a best practices checklist.

Main Results:

• 68 surveys and 14 interviews were completed.
• Pharmacies administered over 700 naltrexone injections in the past year.
• Identified benefits, barriers, and three distinct pharmacy treatment delivery models.

Conclusions:

• Community pharmacies successfully implemented naltrexone injection services.
• Pharmacist and prescriber feedback indicates strong interest in expanding this role.
• Implementation research based on best practices can further optimize pharmacy-based MOUD delivery.