A Foundation to Examine Reasons for Discontinuation for Buprenorphine Care in the Veterans Health Administration (CTN-0087)
This project initiated the largest virtual cohort of patients with OUD on BUP-MOUD. The project achieved a deeper understanding and uncovered contextual issues associated with care, including quality of care provided in each setting. Our results describe BUP-MOUD’s natural course (duration, treatment episodes) and treatment settings; thus helping providers and policymakers understand primary and mental health care environmental contexts.
Node PI: Adam Gordon, MD, MPH
Validation of a Community Pharmacy-based Prescription Drug Monitoring Program Risk Screening Tool (PHARMSCREEN) (NIH HEAL Initiative) (CTN-0093)
Fatal overdose deaths involving prescription opioids, heroin, and synthetic opioids have continued to increase across the US—increasing in 35 states from 2013-2017. Given these persistent trends for adverse opioid-related outcomes in populations across the US, it is critical to work to identify those who are at risk, deliver appropriate care that will help prevent progression to more severe opioid-related outcomes, and provide referral and treatment resources to those who suffer from opioid use disorder (OUD). Therefore, it is necessary to expand the continuum of care to health care settings that previously may have been underutilized. One underutilized resource for addressing the current opioid epidemic is community pharmacies. The most important clinical tool pharmacists have available to identify possible misuse of opioid medications is prescription drug monitoring programs (PDMP), which capture patient-level prescription dispensing information to inform monitoring, dispensing decisions, and possible intervention. These tools are available in all US states and have the potential to enable pharmacists to identify patients at-risk for opioid-related adverse events, such as addiction and overdose. In light of the continued escalation of the opioid epidemic nationally, combined with the promising opportunities afforded by the further inclusion of community pharmacy settings for engaging patients with opioid-related risk, it was important to evaluate whether PDMP risk metrics correlated with clinically validated opioid risk tools and if clinically meaningful risk cutoffs existed for PDMP risk metrics.