Olatunbosun Caitlin, Moharram Mostafa, Gottschalk Samantha, Biggs Catherine
Pharmacy Services, Alberta Health Services, Edmonton, Alberta.
Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta.
Can Pharm J (Ott). 2024 Nov 18;158(1):41-46. doi: 10.1177/17151635241286831. eCollection 2025 Jan-Feb.
Opioid toxicity continues to have significant morbidity and mortality in Alberta. Opioid agonist therapy is an effective treatment for opiate use disorder (OUD), with first-line treatment with buprenorphine-naloxone (BUP-NAL) being both highly effective and safe. Barriers to care limit access to treatment, and more access points for treatment are needed. Pharmacists in Alberta have a wide scope of prescribing authority and high accessibility. This study describes the barriers to care and the roles of pharmacists engaged in OUD treatment, and explores the potential for pharmacists to prescribe BUP-NAL to improve access to care.
Semistructured interviews were conducted with pharmacists from Alberta in January 2024. Key informants were identified using professional networks and the reverse snowball method, and continued until data saturation. Thematic analysis was conducted by 2 investigators using open coding.
Ten pharmacists were interviewed, and 4 major themes emerged: barriers to access OUD treatment, the current role of pharmacists in caring for patients with OUD, the future role of pharmacists as prescribers of BUP-NAL, and enabling pharmacists to prescribe. Patients experience many barriers to care, and a complex health system contributes to this. Pharmacists working with patients with OUD are highly knowledgeable and involved in assessing, managing, and monitoring therapy in a multidisciplinary capacity. Extending authority for pharmacists to prescribe BUP-NAL can improve access to care but must consider collaboration and social context.
Pharmacists are skilled and positioned to improve access to care for patients with OUD needing BUP-NAL.
在艾伯塔省，阿片类药物毒性仍然导致严重的发病率和死亡率。阿片类激动剂疗法是治疗阿片类药物使用障碍（OUD）的有效方法，丁丙诺啡 - 纳洛酮（BUP-NAL）作为一线治疗药物既高效又安全。治疗障碍限制了患者获得治疗的机会，因此需要更多的治疗接入点。艾伯塔省的药剂师拥有广泛的处方权且可及性高。本研究描述了治疗障碍以及参与OUD治疗的药剂师的作用，并探讨了药剂师开具BUP-NAL处方以改善治疗可及性的潜力。
2024年1月对艾伯塔省的药剂师进行了半结构化访谈。通过专业网络和反向滚雪球法确定关键信息提供者，访谈持续进行直至数据饱和。两名研究人员采用开放编码进行主题分析。
采访了10名药剂师，出现了4个主要主题：获得OUD治疗的障碍、药剂师目前在照顾OUD患者方面的作用、药剂师作为BUP-NAL处方者的未来作用以及使药剂师能够开具处方的因素。患者在获得治疗方面面临许多障碍，复杂的卫生系统加剧了这一情况。与OUD患者合作的药剂师知识渊博，以多学科的能力参与评估、管理和监测治疗。扩大药剂师开具BUP-NAL处方的权限可以改善治疗可及性，但必须考虑协作和社会背景。
药剂师具备技能且所处位置有利于改善需要BUP-NAL的OUD患者获得治疗的机会。
