Examining structural characteristics for implementing opioid use disorder services in community-based pharmacies

Abstract

Background

Opioid use disorder (OUD) has become a national public health crisis, affecting millions of people in the United States over the last decade. At the same time, the role of community-based pharmacies in addressing the opioid crisis continues to evolve and the implementation of OUD services is on the rise.

Objective

This study identified and analyzed the structural characteristics underlying successful pharmacist-led OUD services within community-based pharmacies.

Methods

A systematic review was conducted. Articles included were written in English in the United States and published in peer-reviewed journals. The articles were sought via PubMed, Embase, and Scopus using permutations of terms such as “opioid use disorder,” “opiate substitution treatment,” and “pharmacy OR pharmacist OR pharmacy services.” The Consolidated Framework for Implementation Research (CFIR) was selected to synthesize the data. Articles were examined for structural characteristics to expose common themes when implementing OUD services.

Results

Full-text screening resulted in 115 articles being included. The articles described 3 broad elements: physical infrastructure (n = 29), information technology infrastructure (n = 42), and work infrastructure (n = 68). Many articles emphasized having a defined process for workflow and prescription drug monitoring program technology to implement successful OUD services in their pharmacies.

Conclusion

This study contributes to the growing need for analysis of structural characteristics when implementing OUD services in community-based pharmacies. Continued progression is needed within the work infrastructure, such as training pharmacy staff, and physical infrastructure, such as stocking medications for OUD treatment, to successfully implement these services. This review may serve as a blueprint for community-based pharmacies to implement OUD services within their own communities. Future research should expand on other CFIR domains to evaluate other factors that have an impact on the implementation of new OUD services.