The role of Alberta pharmacists working in opioid use disorder and their potential to prescribe buprenorphine-naloxone: A qualitative study.

Abstract

Opioid toxicity continues to have significant morbidity and mortality in Alberta. Opioid agonist therapy is an effective treatment for opiate use disorder (OUD), with first-line treatment with buprenorphine-naloxone (BUP-NAL) being both highly effective and safe. Barriers to care limit access to treatment, and more access points for treatment are needed. Pharmacists in Alberta have a wide scope of prescribing authority and high accessibility. This study describes the barriers to care and the roles of pharmacists engaged in OUD treatment, and explores the potential for pharmacists to prescribe BUP-NAL to improve access to care. Semistructured interviews were conducted with pharmacists from Alberta in January 2024. Key informants were identified using professional networks and the reverse snowball method, and continued until data saturation. Thematic analysis was conducted by 2 investigators using open coding. Ten pharmacists were interviewed, and 4 major themes emerged: barriers to access OUD treatment, the current role of pharmacists in caring for patients with OUD, the future role of pharmacists as prescribers of BUP-NAL, and enabling pharmacists to prescribe. Patients experience many barriers to care, and a complex health system contributes to this. Pharmacists working with patients with OUD are highly knowledgeable and involved in assessing, managing, and monitoring therapy in a multidisciplinary capacity. Extending authority for pharmacists to prescribe BUP-NAL can improve access to care but must consider collaboration and social context. Pharmacists are skilled and positioned to improve access to care for patients with OUD needing BUP-NAL.