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Impact of Pharmacist-Led Education and Order Panel Implementation on Alcohol Use Disorder Treatment in the Primary
Wendy Xia1, Aletha Loeb1, Ellen Berkley1
1University of California, Davis Health, Sacramento, California, USA.
Background:
Alcohol use disorder (AUD) remains undertreated in the United States despite the availability of effective pharmacotherapies. Pharmacist-led education and clinical decision support embedded in the electronic medical record (EMR) was provided to primary care providers (PCPs) to address barriers to prescribing medications for AUD. This study evaluated the impact of the pharmacist-led intervention on pharmacologic treatment rates for patients with AUD managed by PCPs.
Methods:
This was a retrospective, fixed cohort, pre-post study conducted across a network of 10 clinics within a single health system. The study included patients 18 years and older with an AUD diagnosis managed by a PCP within the institution. The cohort of patients was utilized to evaluate PCP prescribing rates for pharmacologic treatment of AUD. The pre-intervention period was from July 2021 to July 2022, and the post-intervention period was from August 2023 to August 2024. Pharmacists created and delivered educational tools and EMR enhancements to PCPs. The primary outcome was the pharmacologic treatment rate of AUD. Secondary outcomes included clinic-level pharmacologic treatment rates and associations between patient factors and treatment. Statistical analyses were conducted utilizing descriptive statistics, McNemar's test, and a logistic regression model.
Results:
Of the 800 patients screened, 441 met inclusion criteria. The baseline pharmacologic treatment rate for patients with AUD was 7%. After the intervention, the pharmacologic treatment rate increased to 18% (p < 0.001). Treatment rates increased in eight out of 10 clinics. Concurrent benzodiazepine use was associated with an increased treatment rate (p = 0.0062) while no associations were found with concurrent opioid use, tobacco use, methamphetamine use, chronic kidney disease, or cirrhosis.
Conclusion:
The pharmacist-led intervention more than doubled the pharmacologic treatment rate for AUD in primary care.
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