Collaborative approach to harm reduction by managed care pharmacy team for populations with substance use disorder

Abstract

BackgroundOregon has one of the highest rates of substance use and substance use disorders (SUDs) in the nation. To improve access to SUD treatment in Oregon, CareOregon clinical pharmacists in collaboration with the behavioral health team have implemented these best practices to support members with SUD. ObjectiveThe primary objective of this article is to describe the various harm reduction programs and interventions implemented by managed care clinical pharmacists at CareOregon to prevent overdose and ensure improved health outcomes for populations with SUD. Practice descriptionThe CareOregon team of managed care clinical pharmacists acts as a liaison with provider networks by providing pharmacy benefit knowledge and implementing several interventions and best practices to improve health outcomes for populations with SUD. Practice innovationThe managed care clinical pharmacist team implemented a medication education (MEDS Ed) program to provide educational support to the CareOregon provider network on harm reduction, supported medication for opioid use disorder (MOUD) program initiatives to increase buprenorphine prescribing, and used programs to increase naloxone access for populations at high risk of overdose. Evaluation methodsA mixed-method approach was applied to evaluate the impact of the practice innovations implemented. A qualitative self-assessment questionnaire was used to evaluate the impact of the harm reduction MEDS Ed. Quantitative data accessed via CareOregon’s claims data were used to evaluate the effect of initiatives to expand naloxone access and increase buprenorphine prescribing. ResultsThe CareOregon provider network reported an increase in knowledge about harm reduction by attending the MEDS Ed training. From the first quarter of 2019 to the second quarter of 2022, the number of naloxone prescriptions filled increased by 346%. From the third quarter of 2017 to the first quarter of 2022, the number of Drug Addiction Treatment Act–waivered providers prescribing buprenorphine increased by 331%. As a result, the number of prescriptions for MOUD doubled during this period. ConclusionThe harm reduction interventions implemented by the managed care clinical pharmacist team at CareOregon were successful in improving knowledge on harm reduction and increasing naloxone access and buprenorphine prescribing for populations at risk of opioid use disorder.