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Published on: November 6, 2018
Qualitative study of blister pack use during buprenorphine low dose initiation
Summary
Buprenorphine blister packs simplify low-dose initiation (LDI) for opioid use disorder, reducing errors and improving adherence. Collaboration with pharmacies and clear protocols are key to successful implementation.
Area of Science:
- Pharmacology and Addiction Treatment
- Patient Adherence Strategies
- Healthcare Implementation Science
Background:
- Buprenorphine low-dose initiation (LDI) protocols are effective but challenging for patients in outpatient settings due to complex dosing regimens.
- Blister packs offer a structured solution by pre-packaging and pre-splitting buprenorphine doses, simplifying LDI.
- Limited data exists on the real-world implementation and patient/provider experiences with buprenorphine blister packs.
Purpose of the Study:
- To explore healthcare provider and patient attitudes towards outpatient buprenorphine LDI using blister packs.
- To gain insights into the practical use of blister packs in real-world settings.
- To inform future blister-packing implementation strategies for buprenorphine LDI.
Main Methods:
- Qualitative study involving interviews with 33 participants: 9 buprenorphine prescribers, 5 pharmacists, and 19 patients with opioid use disorder.
- Participants had attempted LDI within the past 3 months.
- Interviews were conducted at safety-net substance use clinics and a community behavioral health pharmacy, followed by thematic analysis.
Main Results:
- Blister packing significantly eased LDI and reduced medication errors for patients.
- Close collaboration with a public health pharmacy, including dedicated workflows and protocols, was crucial for successful implementation.
- Challenges in blister pack preparation and packaging were identified as barriers to wider pharmacy adoption.
Conclusions:
- Buprenorphine blister packs are a valuable tool for successful outpatient LDI completion.
- Standardized protocols and strong collaboration with pharmacists are key facilitators for implementation.
- Engaging local pharmacies, educating pharmacists, and addressing preparation/packaging barriers can expand the use of buprenorphine LDI blister-packing.
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