California-Pharmacist-Winter-2024 - Flipbook - Page 23
peer-to-peer
Pharmacist Management of Opioid Use Disorder
With Injectable Buprenorphine
Christina Nguyen, Lawrence Chang, Sophie Nguyen, Jackie Alba-Nguyen, Jenni Nguyen, Jennefer Yoon,
Narinder Singh, and Michael Wong
Abstract
Purpose
To describe the role clinical pharmacists can provide
in managing patients with opioid use disorder (OUD)
using long-acting injectable buprenorphine (LAI-bup)
in a primary care setting for patients experiencing
homelessness or with histories of incarceration.
Methods
A retrospective chart review, from January to March of
2021 and 2023, was performed to analyze data before
and after the implementation of a clinical pharmacist
who managed OUD with LAI-bup through a collaborative
practice protocol. The pharmacist closely followed up with
patients, coordinating delivery of the injection, assessing
adherence, relapse, and withdrawal symptoms, and
prescribing supplemental sublingual buprenorphine if
patients experienced withdrawal symptoms or cravings.
The primary outcome examined adherence before and
after pharmacist intervention through portions of days
covered (PDC) and patient-reported relapse. Secondary
outcomes were the number of patients who reached
maintenance dose, received supplemental buprenorphine,
and emergency department visits or overdoses.
intervention, about 5% of patients reached the
maintenance dose of LAI-bup compared to 31% after
pharmacist intervention. Patients also self-reported
improved management of withdrawal symptoms and
cravings while under pharmacist management.
Conclusion
Pharmacists can play a vital role in helping patients with
opioid use disorder maintain sobriety and improve access
to medication treatment for opioid use disorder by assisting
with the management of LAI-bup.
Calif Pharm. 2024(winter);71(4):22-27
Christina Nguyen, PharmD; Lawrence Chang, PharmD,
BCACP, APh; Sophie Nguyen, PharmD; Jenni Nguyen,
PharmD; Jennefer Yoon, PharmD; Narinder Singh,
PharmD, MBA; and Michael Wong, PharmD, are with the
County of Santa Clara Health System, Valley Homeless
Healthcare Program, and the Department of Pharmacy
Services, Santa Clara Valley Medical Center, San Jose,
California.
Jackie Alba-Nguyen, MD, is with the County of Santa Clara
Health System and the Department of Medicine, Santa
Clara Valley Medical Center, San Jose, California.
Results
There was a 7% increase in PDC with pharmacist
management of LAI-bup. After pharmacist intervention,
patient-reported opioid relapse decreased by 18% in
the control versus treatment groups. Before pharmacist
Correspondence: Lawrence Chang, lawrence.chang@hhs.
sccgov.org
Introduction
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Connicts of Interest: The authors declare no connicts of
interest.
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California Pharmacist | vol. 71, no. 4
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