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Evaluation of Outcomes for Veterans With Opioid Use Disorder Managed by a Clinical Pharmacist Practitioner
Lydia Jackson1, Christina White1, William Frizzell1
1Robley Rex Veterans Affairs Medical Center, Louisville, Kentucky, USA.
Background:
Opioid use disorder (OUD) has been a growing concern in the United States, and there are significant barriers to accessing timely and consistent treatment. Veterans face disproportionately high rates of OUD, often accompanied by higher rates of mental health disorders and chronic pain. Clinical Pharmacist Practitioners (CPPs) have emerged as key contributors in delivering Medication for Opioid Use Disorder (MOUD) as part of interdisciplinary care teams. The objectives of this study were to determine whether Veterans with OUD managed by a Substance Use Disorder (SUD) CPP have clinical outcomes comparable with those managed by physicians or nurse practitioners (MD/NPs).
Methods:
A single-center, retrospective cohort study was conducted at the Robley Rex Veterans Affairs Medical Center (RRVAMC). Veterans with MOUD initiated between June 1, 2023 and February 12, 2025 who attended at least three follow-up appointments were included. Patients were grouped by primary provider (CPP vs. MD/NP). The primary outcome was a composite of nonfatal overdose, OUD-related hospitalization, and OUD-related emergency department (ED) visits. Secondary outcomes included individual components of the primary outcome, all-cause mortality, no-show rates, active naloxone prescriptions, prescription drug monitoring program (PDMP) screening completion, suicide risk screening completion, and positive urine drug screen (UDS) results.
Results:
Seventy-seven patients were included (CPP group, n = 34; MD/NP group, n = 43). There was no statistically significant difference in the primary composite outcome between groups. CPPs had statistically significant higher PDMP screening completion rates. No significant differences were noted in other secondary outcomes.
Conclusion:
CPPs provided MOUD care that was safe and effective, with outcomes comparable with those of physicians and nurse practitioners. Their increased use of risk mitigation tools such as PDMP underscores the value of CPP integration into MOUD programs, which can increase access to SUD care.
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