Pharmacist-delivered comprehensive medication management in a substance use disorder clinic, an 18-month descriptive study

Introduction: Pharmacists have expanded their roles within interprofessional teams in substance use disorder (SUD) care, but data characterizing pharmacist-delivered comprehensive medication management (CMM) in outpatient SUD treatment are limited. Objectives: The purpose of this study was to characterize the patient population, and medication therapy problems (MTPs), and describe considerations for CMM development and implementation in an outpatient SUD treatment setting. Methods: An observational, prospective, descriptive study was conducted in an outpatient SUD center. A clinical pharmacist provided CMM services to referred clients and documented data elements after each visit. The pharmacist comprehensively assessed clients' complete regimens to optimize medication use through collaboration with the clients and other healthcare providers. A post-CMM electronic survey was sent to the clients' care teams to assess their attitudes and collect feedback regarding the collaboration process. Descriptive statistics were employed to describe the population, CMM services, MTPs, and survey responses. Results: From April 1, 2021, to September 30, 2022, a total of 187 CMM encounters were delivered to a total of 112 clients with SUD. Nearly all patients (99%) had opioid use disorder as their primary diagnosis and the vast majority (95%) were receiving methadone treatment. Clients’ mean age was 39-years-old with an average of eight medications and six medical conditions. Of 201 MTPs identified, 54 MTPs (27%) were marked as “resolved” at follow-up visits. The most commonly identified MTP category was the need for additional drug therapy (31%). The care team survey showed 100% agreed or strongly agreed that the CMM consult was helpful to the clients and the care team members. Conclusion: Pharmacist-delivered CMM in a SUD treatment setting was feasible and well perceived by care team members as helpful to bridge existing gaps in access to biomedical care, medication optimization, and medication use care coordination.