Role of the pharmacist in acute care interventions for opioid use disorder: A scoping review

Abstract

Opioid use disorder (OUD) is associated with significant morbidity and mortality in the United States. In recent years, interest in initiatives to increase access to medication for OUD (MOUD) and overdose-reversing medications (naloxone) in acute care has grown. While well positioned to intervene, the role of acute care pharmacists in these interventions is not known. The objective for this scoping review was to better understand what is presently known about the role of pharmacists in acute care OUD interventions. These were defined as initiatives implemented in either inpatient or emergency department (ED) settings aimed at treatment of OUD (eg, initiation or management of MOUD) or harm reduction in individuals with OUD (eg, education or targeted naloxone dispensing). PubMed/MEDLINE and Embase databases were searched for articles pertaining to the research question from inception to 19 May 2021. Pearling was performed after the identification of eligible articles. Articles had to explicitly describe the pharmacist's role in planning, implementing, or evaluating an OUD intervention in the inpatient or ED setting. Data charting was performed by both authors using a predefined template, and data synthesis was performed via discussion between authors. The initial title search yielded 101 references which were screened and resulted in four articles that met inclusion criteria. Three additional articles were identified in the pearling process, yielding a total of seven articles. Four described initiatives aimed at point-of-care dispensing of naloxone, and three described initiatives for provision or management of MOUD. Pharmacist roles primarily consisted of medication use process management, hospital staff and patient education, and dispensing activities. Literature describing the role of pharmacists in acute care OUD interventions is limited. Given the burden of OUD, there are many opportunities for further exploration of the roles acute care pharmacists can play in OUD harm reduction and treatment.