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MAT for OUD Initiated by Pharmacists Increases Patient Engagement in Pilot
Pharmacists can safely and effectively start patients with opioid use disorder (OUD) on buprenorphine, according to a new pilot study from researchers at Brown University, Rhode Island Hospital, and the University of Rhode Island.
The findings, which were published this week in the New England Journal of Medicine, could unlock a new option for expanding access to medication-assisted treatment for OUD, particularly for underserved populations.
“Dramatically increasing capacity to provide good, lifesaving treatment for people with opioid use disorder through pharmacies is an approach that could be ramped up today,” study lead author Traci Green, co-director of Rhode Island Hospital’s Center of Biomedical Research Excellence on Opioids and Overdose and an adjunct professor at Brown University's Warren Alpert Medical School, said in a news release. “It’s a game-changer.”
The 100 patients included in the study were provided with buprenorphine after visiting a specially trained pharmacist. At the pharmacy, patients filled prescriptions, obtained medication management, and received follow-up care.
Once stabilized, 58 of the patients were randomly assigned to receive continued care in the pharmacy or in a traditional clinic or physician’s office setting. After a month, 89% of the pharmacy care group patients continued receiving treatment compared to 17% of those continuing care in a clinic or physician’s office.
Of the 100 participants in the study, a third identified as Black, indigenous, or persons of color, and nearly half did not have a permanent residence.
“Considering overdose deaths are increasing the fastest among Black and Hispanic communities and over 1500 Rhode Islanders are currently unhoused, pharmacy-based addiction care models could be a pathway to promote racial and economic equity in accessing addiction treatment,” study author Dr Josiah D. Rich, a professor of medicine and epidemiology at Brown University, said in the release.
“Treatment with medications can only work if it is available and accessible in the community. … Our study showed that the pharmacy treatment model increases access, which benefits a diverse population and increases equity.”
Ten states currently allow pharmacists to obtain authorization from the Drug Enforcement Administration (DEA) to prescribe controlled substances, including buprenorphine. The Mainstreaming Addiction Treatment (MAT) Act, however, which was included in the omnibus bill signed by President Joe Biden on December 29, 2022, removes the waiver requirement, a step designed to increase the number of providers who are able to prescribe buprenorphine.
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