Clinical Scorecard: Assessing the Feasibility of a Pharmacist-Integrated Collaborative Care Model for Opioid Use Disorder: A Nonrandomized Clinical Trial
At a Glance
Category
Detail
Condition
Clinical topic addressed by the source article: Assessing the Feasibility of a Pharmacist-Integrated Collaborative Care Model for Opioid Use Disorder
Key Mechanisms
PrIMO incorporates pharmacists into interdisciplinary OUD care teams. Its six core components are collaborative communication, weekly clinical huddles, provider education, patient education, comorbidity screening, and education for local partners. Pharmacists collaborate with prescribers on medication expertise, including interaction assessment, dose adjustments, and prior authorizations, and provide direct patient consultation.
Target Population
Clinic personnel and adult patients receiving MOUD who had experienced PrIMO for at least two weeks and could provide consent.
Care Setting
Care setting described in the source article.
Key Highlights
This was a nonrandomized, unassigned, unblinded longitudinal feasibility and implementation trial conducted from August 2022 to July 2024.
PrIMO’s six core components are collaborative communication, weekly clinical huddles, provider education, patient education, comorbidity screening, and education for local partners.
Pharmacists collaborated with prescribers on medication interactions, dose adjustments, prior authorizations, and direct patient consultations.
The primary feasibility measure was implementation launch, defined as reaching Stage 6, Milestone B, of the tailored Stages of Implementation Completion instrument.
The project’s limited duration precluded a true assessment of sustainability.
Guideline-Based Recommendations
Diagnosis
Management
PrIMO integrates pharmacists into OUD care teams that include prescribers, nurses, social workers, and therapists.
The model uses weekly huddles for active clinical decision-making and care-plan modification for every patient with OUD.
Pharmacists provide medication expertise and direct patient consultation in collaboration with prescribers.
Monitoring & Follow-up
Risks
The article notes barriers affecting MOUD access and quality and reports that most primary care providers do not prescribe buprenorphine.
The study was nonrandomized and unblinded.
Patient & Prescribing Data
Adult patients receiving MOUD who had experienced PrIMO for at least two weeks and could provide consent.
Participating sites provided buprenorphine and/or naltrexone. Patients received PrIMO as usual care; the model included pharmacist consultation and patient education.
Clinical Best Practices
PrIMO uses interdisciplinary collaboration among pharmacists, prescribers, nurses, social workers, and therapists.
The model includes weekly team huddles for clinical decision-making and care-plan modification for patients with OUD.
Pharmacist activities include medication-interaction assessment, dose-adjustment support, prior-authorization assistance, and direct patient consultation.
Implementation was supported by a toolkit and monthly meetings with model developers and external facilitators.
by Felicity Homsted, David A. Fiellin, Udi E. Ghitza, Vernon T. Gardner, Bethany McLeman, Paul J. Joudrey, Gerald Cochran, Sarah K. Moore, Lisa Saldana, Edward Chongsi, Kimberly Kramer, Ashley Vena, Rebecca A. Ottesen, Jacklyn Harris, Jesse S. Boggis, Deepika Rao, Owen Murray, Scott Gerlach, Phoebe Gauthier, Katie P. Osterhage, Laura-Mae Baldwin, Lisa A. Marsch
