Addition of a clinical pharmacist practitioner to an inpatient addiction triage team and related medication outcomes.

Abstract

Introduction: At a Veterans Affairs Medical Center (VAMC), a clinical pharmacist practitioner (CPP) was added to an inpatient addiction triage team in August 2019 to provide education and recommendations regarding medications for alcohol use disorder (MAUD) and opioid use disorder (MOUD). Before the addition of the CPP, missed opportunities for MAUD and MOUD education and prescribing prior to discharge on non-psychiatric units were observed.

Methods: This was a single-center, single-site, retrospective, observational cohort study with a primary objective to compare initiation rates of MAUD/MOUD 12 months before and after the addition of the CPP to the addiction triage team. Secondary end points included 90-day medication possession ratio, 1- and 3-month emergency department visit rates, 1- and 3-month hospital readmission rates, and opioid education and naloxone distribution interventions for eligible patients with a diagnosis of opioid use disorder.

Results: Both statistically and clinically significant improvements in MAUD/MOUD initiation rates were found in the CPP intervention group compared with the historical control group (26.3% vs 4%, P < .0001). Although secondary end points within this review were not found to be statistically significant, improvements were seen in the CPP intervention group compared with the historical control group related to medication possession ratio, and emergency department and hospital readmission rates.

Discussion: This study highlights the potential utility of a CPP to an inpatient addiction triage team to improve MAUD/MOUD prescribing rates in appropriate patients prior to discharge. Overall, the introduction of a CPP to an inpatient addiction triage team was feasible, well received by interprofessional team members, and required limited additional resources.