The article, “Care Practices of Mental Health Clinical Pharmacist Practitioners Within an Interdisciplinary Primary Care Model for Patients With Substance Use Disorders,” has been published in SAj.
In this commentary, the authors state that clinical pharmacist practitioners (CPPs) play an increasingly important role in interdisciplinary care for patients with substance use disorders (SUDs). However, CPPs’ scope of practice varies substantially across clinics and settings. The authors sought to describe CPP practices and activities within an interdisciplinary, team-based primary care clinic dedicated to treat Veterans with histories of substance use disorders, experience of homelessness, high medical complexity, and other vulnerabilities.
In the AUTHORS’ OWN WORDS, they relate the importance of their work:
“Nearly 1 in 7 primary care patients meet criteria for a substance use disorder (SUD), yet most patients with SUDs do not receive evidence-based treatment. Emergency department visits attributed to SUD-related causes increased by 45% from 2013 to 2018. With rising opioid-related overdoses and deaths, there have been calls for primary care to assume a greater role in providing treatment for SUDs, including opioid use disorder (OUD). However, system and provider barriers persist. Primary care providers (PCPs) often describe time constraints and lack of support staff as key barriers to prescribing medications for opioid use disorder (MOUD), even after receiving certified training to do so. Expanding the role of clinical pharmacist practitioners (CPPs) within primary care could address PCP staff shortages, mitigate time and resource barriers to medication treatment for SUDs, and prevent more costly hospital-based services.”
“Our study adds to the literature in several important ways. First, while other primary care-based studies that have utilized CPPs have shown effectiveness of CPPs for treating a single condition such as OUD alone, we found that mental health CPPs can successfully manage patients in a primary care setting when illness severity and medical complexity are high. Second, while previous studies have shown promise for CPPs in limited ways (eg, through small patient panels or restricted autonomy such as only following patients already stabilized on medications for SUDs), this study depicts successful CPP care management for a large patient panel where CPPs had autonomy to initiate medication treatment (ie, 5% of OUD interventions and 10% of AUD interventions performed by CPPs). The VA allows for CPPs to be co-located within primary care clinics and, in the present interdisciplinary clinic, the 2 CPPs collaborated closely with PCPs under their scope of practice. Thus, our results offer an example of how adding mental health CPPs to primary care settings can support PCPs in providing SUD care.”