Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, USA.
Minneapolis VA Health Care System, Minneapolis, MN, USA.
Am J Health Syst Pharm. 2021 Feb 8;78(4):354-359. doi: 10.1093/ajhp/zxaa405.
The rise in opioid prescribing, often for chronic pain management, resulted in an increased prevalence of opioid use disorder (OUD) throughout the United States, including within the Veterans Affairs (VA) healthcare system. The veteran population has been especially vulnerable to opioid-related harms, but rates of prescribing medications for OUD have been low. Use of care manager models for OUD have increased access to treatment. In this article we provide an overview of a clinical pharmacist care manager (CPCM) model for medications for OUD treatment implemented within the Minneapolis Veterans Affairs Health Care System.
A CPCM model for medications for OUD was identified as a care model that would address patient and facility barriers to effective OUD treatment. Pharmacists were integral in program development and implementation and served as the main care providers. An interim evaluation of the program established that the proportion of patients with OUD receiving medications for opioid use disorder (MOUD) had increased, with use of the program resulting in treatment of 109 unique patients during 625 visits. Key program implementation facilitators included the facility leadership establishing increased use of MOUD as a priority area, identification of a physician champion, and a history of successful expansion of clinical pharmacy specialist practice within the VA system. Implementation barriers included factors related to provider engagement, patient identification, and program support. The CPCM model of provision of MOUD expanded the pharmacist role in buprenorphine management.
The need to increase the number of patients receiving MOUD led to the implementation of a CPCM model. The program was effectively implemented into practice and expanded the availability of MOUD, which allowed patients to access treatment in multiple care settings.
阿片类药物处方的增加，通常用于慢性疼痛管理，导致阿片类药物使用障碍（OUD）在美国各地的流行率增加，包括退伍军人事务部（VA）医疗保健系统。退伍军人特别容易受到阿片类药物相关伤害，但用于治疗 OUD 的药物处方率一直很低。使用 OUD 护理经理模型增加了获得治疗的机会。在本文中，我们概述了明尼苏达州退伍军人事务医疗保健系统实施的治疗 OUD 药物的临床药师护理经理（CPCM）模型。
阿片类药物使用障碍治疗药物的 CPCM 模型被确定为一种可以解决患者和医疗机构有效治疗 OUD 障碍的护理模式。药剂师是方案制定和实施的重要组成部分，也是主要的护理提供者。该方案的中期评估表明，患有 OUD 的患者接受阿片类药物使用障碍治疗药物（MOUD）的比例有所增加，该方案在 625 次就诊中治疗了 109 名独特的患者。关键的方案实施促进因素包括医疗机构领导层将增加 MOUD 的使用作为优先事项，确定一名医生倡导者，以及 VA 系统内临床药学专家实践成功扩展的历史。实施障碍包括与提供者参与、患者识别和方案支持相关的因素。提供 MOUD 的 CPCM 模型扩展了药剂师在丁丙诺啡管理中的作用。
需要增加接受 MOUD 的患者数量，这导致了 CPCM 模型的实施。该方案已成功实施，并扩大了 MOUD 的可及性，使患者能够在多个护理环境中获得治疗。
