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Implementing a pharmacist-integrated collaborative model of medication treatment for opioid use disorder in primary care: study design and methodological considerations


Journal Article

McLeman, B.; Gauthier, P.; Lester, L. S.; Homsted, F.; Gardner, V., 3rd; Moore, S. K.; Joudrey, P. J.; Saldana, L.; Cochran, G.; Harris, J. P.; Hefner, K.; Chongsi, E.; Kramer, K.; Vena, A.; Ottesen, R. A.; Gallant, T.; Boggis, J. S.; Rao, D.; Page, M.; Cox, N. ; Landiorio, M.; Ambaah, E. ; Gitza, U.; Fiellin, D. A.; Marsch, L. A.




Addict Sci Clin Pract




Humans Pharmacists Research Design Medication Adherence *Opioid-Related Disorders/drug therapy Primary Health Care *Buprenorphine Buprenorphine Evidence-based pharmacy practice Feasibility studies Implementation science Medications for opioid use disorder Opioid use disorder

BACKGROUND: Pharmacists remain an underutilized resource in the treatment of opioid use disorder (OUD). Although studies have engaged pharmacists in dispensing medications for OUD (MOUD), few studies have evaluated collaborative care models in which pharmacists are an active, integrated part of a primary care team offering OUD care. METHODS: This study seeks to implement a pharmacist integrated MOUD clinical model (called PrIMO) and evaluate its feasibility, acceptability, and impact across four diverse primary care sites. The Consolidated Framework for Implementation Research is used as an organizing framework for study development and interpretation of findings. Implementation Facilitation is used to support PrIMO adoption. We assess the primary outcome, the feasibility of implementing PrIMO, using the Stages of Implementation Completion (SIC). We evaluate the acceptability and impact of the PrIMO model at the sites using mixed-methods and combine survey and interview data from providers, pharmacists, pharmacy technicians, administrators, and patients receiving MOUD at the primary care sites with patient electronic health record data. We hypothesize that it is feasible to launch delivery of the PrIMO model (reach SIC Stage 6), and that it is acceptable, will positively impact patient outcomes 1 year post model launch (e.g., increased MOUD treatment retention, medication regimen adherence, service utilization for co-morbid conditions, and decreased substance use), and will increase each site's capacity to care for patients with MOUD (e.g., increased number of patients, number of prescribers, and rate of patients per prescriber). DISCUSSION: This study will provide data on a pharmacist-integrated collaborative model of care for the treatment of OUD that may be feasible, acceptable to both site staff and patients and may favorably impact patients' access to MOUD and treatment outcomes. TRIAL REGISTRATION: The study was registered on (NCT05310786) on April 5, 2022, https://www. CLINICALTRIALS: gov/study/NCT05310786?id=NCT05310786&rank=1.

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