临床药剂师从业者开具丁丙诺啡用于阿片类物质使用障碍的处方。

Clinical pharmacist practitioners prescribing of buprenorphine for opioid use disorder.

作者信息

Baylis Jacob D, Jorgenson Terri L, Pals Haley E, Hwang Catherine S, Colvard Michelle D, Alliu Veldana, Moore Tera, Lin Lewei A, Wyse Jessica, Hawkins Eric J, Hagedorn Hildi J, Gordon Adam J

机构信息

Vulnerable Veteran Innovative Patient-aligned Care Team (VIP), Informatics, Decision-Enhancement and Analytic Sciences (IDEAS) Center, VA Salt Lake City Health Care System, Salt Lake City, UT, USA; Program for Addiction Research, Clinical Care, Knowledge, and Advocacy (PARCKA), Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA.

Clinical Pharmacy Practice Office, Pharmacy Benefits Management, Veterans Health Administration, Department of Veterans Affairs, USA.

出版信息

Drug Alcohol Depend. 2025 Jun 1;271:112663. doi: 10.1016/j.drugalcdep.2025.112663. Epub 2025 Mar 26.

DOI:10.1016/j.drugalcdep.2025.112663

PMID:40228325

Abstract

BACKGROUND

Clinical Pharmacist Practitioners (CPPs) have a long history of collaborating with other prescribers for the provision of buprenorphine medication treatment for opioid use disorder (B-MOUD). In January 2023, with the removal of the DATA 2000 X-waiver process, CPPs were allowed to prescribe B-MOUD in states that allow CPP prescriptive authority of controlled substances. We sought to examine CPP prescribing patterns of B-MOUD in a large heath care system in 2023.

METHODS

We conducted a retrospective cohort study of patients with opioid use disorder (OUD) who received B-MOUD care in 2023 within the Veterans Health Administration (VHA). B-MOUD was defined as a formulation of buprenorphine indicated for OUD. We characterized Veterans who were prescribed B-MOUD by CPPs and examined the characteristics of these prescriptions and the episodes of care (EOC).

RESULTS

In 2023, 22,863 Veterans received B-MOUD; 1090 (4.8 %) from a CPP. Veterans prescribed B-MOUD by CPPs were primarily 36-50 years old (n = 419, 38.4 %), male (n = 987, 90.6 %), white (n = 987, 90.6 %), non-Hispanic/Latino (n = 1043, 95.7 %), and in urban areas (n = 648, 59.4 %). 110 CPPs prescribed B-MOUD in 36 states representing 1.9 % of all B-MOUD prescribers in 2023. CPPs prescribed 5258 B-MOUD prescriptions, conducted 339 (2.7 %) initiations, were involved in 1162 (4.2 %) of all EOC throughout the year, and were the sole prescriber for 16.6 % of EOC. CPP-involved EOC had 86.9 % (n = 867) 90-day retention.

CONCLUSION

When they were able to, VHA CPPs were early adopters in prescribing B-MOUD. B-MOUD prescribing by CPPs is an emerging opportunity to further expand access to B-MOUD.

摘要

背景

临床药剂师从业者（CPPs）在与其他开处方者合作提供丁丙诺啡药物治疗阿片类物质使用障碍（B - MOUD）方面有着悠久的历史。2023年1月，随着DATA 2000 X豁免程序的取消，在允许CPPs拥有受控物质处方权的州，CPPs被允许开具B - MOUD处方。我们试图研究2023年在一个大型医疗保健系统中CPPs开具B - MOUD的处方模式。

方法

我们对2023年在退伍军人健康管理局（VHA）接受B - MOUD治疗的阿片类物质使用障碍（OUD）患者进行了一项回顾性队列研究。B - MOUD被定义为用于OUD的丁丙诺啡制剂。我们对由CPPs开具B - MOUD处方的退伍军人进行了特征描述，并检查了这些处方和护理事件（EOC）的特征。

结果

2023年，22863名退伍军人接受了B - MOUD治疗；其中1090人（4.8%）由CPPs开具处方。由CPPs开具B - MOUD处方的退伍军人主要年龄在36 - 50岁（n = 419，38.4%），男性（n = 987，90.6%），白人（n = 987，90.6%），非西班牙裔/拉丁裔（n = 1043，95.7%），且居住在城市地区（n = 648，59.4%）。2023年，110名CPPs在36个州开具了B - MOUD处方，占所有B - MOUD开处方者的1.9%。CPPs开具了5258份B - MOUD处方，进行了339次（2.7%）起始治疗，参与了全年所有EOC的1162次（4.2%），并且是16.6%的EOC的唯一开处方者。由CPPs参与的EOC有86.9%（n = 867）的90天留存率。