Transcript Community Services Presentation

A Pharmacist’s journey: the
development of targeted opportunistic
multi-disciplinary team training in the
treatment of opioid dependence
Kevin Foreman
Dr R Parige
AUA MPS PHC
Pharmacist Health Professional Level 6
Alcohol and Drug Program
Mental Health, Justice Health and Alcohol and Drug Services
ACT Health Directorate
Adjunct Professional Associate
University of Canberra Discipline of Pharmacy
MD FAChAM MRO(USA)
Senior Specialist
Alcohol and Drug Program
Mental Health, Justice Health and Alcohol and Drug Services
ACT Health Directorate
Ben Gilbert
BPharm GradDipTox GCHE MPS AACPA
Lecturer in Pharmacy
Faculty of Health, Discipline of Pharmacy
University of Canberra
Jill Hughes
Manager of Clinical Services
Alcohol and Drug Program
Mental Health, Justice Health and Alcohol and Drug Services
ACT Health Directorate
Issue
 Training on the treatment of opioid dependence:
 From 2001-2010 training in the ACT was limited to
infrequent day-long seminars
 This was seen to limit accessibility and opportunities for
inter-professional collaboration
Issue
 Training on the treatment of opioid dependence:
 From 2001-2010 training in the ACT was limited to
infrequent day-long seminars
 This was seen to limit accessibility and opportunities for
inter-professional collaboration
 This has recently been successfully addressed by the
development and delivery of targeted opportunistic
multi-disciplinary team training
Issue
 Previously:
 In 2001 the ACT Health Alcohol and Drug Services Senior
Pharmacist identified a need for multi-disciplinary training
for pharmacists, GPs and nurses
 With the support of addiction specialists and nursing
management, day-long multi-disciplinary training seminars
were conducted annually or bi-annually
Issue
 In 2010:
 The ACT Opioid Maintenance Treatment Guidelines were
introduce by ACT Health

The Guidelines are an instrument under the Medicines, Poisons
and Therapeutic Goods Regulation, as approved by the Minister
 The Guidelines require compulsory training for all
pharmacists to be accredited by ACT Health to dispense
opioid maintenance treatment
Approach
 This led to an increased and sustained demand for
training, and prompted the development of targeted
opportunistic multidisciplinary training as a novel solution
Approach
 Targeted:
 all pharmacists working in the ACT and surrounding areas are
specifically contacted about OMT training
 Opportunistic:
 training sessions are held on an “as needed” basis in a variety of
locations according to convenience and group size


Training sessions are held in the workplace, at formal sessions, at the
ADP offices, at University seminars, during student placements etc.
Training sessions are arranged for individuals, groups, workplaces,
organisations, students etc.
Approach
 Multidisciplinary:
 Training was initially delivered to pharmacists, intern pharmacists
and pharmacy students
 Training has now been successfully delivered to doctors, nurses
and social workers involved in OMT
Key findings
 Since June 2010, 519 health professionals have attended
68 training events:
 415 pharmacists (including students and interns)
 44 doctors
 58 nurses
 2 social workers
Approach
 The training covers:
 Best practice and risk management of the OMT dosing
process (methadone and buprenorphine +/- naloxone)
 Clinical risks and risk mitigation during induction of patients
onto OMT
 Practical examples of pragmatic risk reduction activities
 Problem solving strategies and emergency communication
 A Certificate of Training is awarded after completing the
training course and assessment
Certificate of training
This is to certify that
Has met the training requirements of the ACT Opioid Maintenance Treatment Guidelines to undertake opioid
dependency treatment in a licensed Opioid Dependency Treatment Centre.
The ACT Opioid Maintenance Treatment Guidelines is an instrument under the Medicines, Poisons and
Therapeutic Goods Act 2008.
Date
14/4/2011
Kevin Foreman
Senior Pharmacist
Expiry 14/4/2016
Key findings
 The accessibility and consistency of these training events
has provided a common understanding of the issues
involved whilst also catering for individual profession’s
needs, and has been seen to greatly enhance a team
approach to treatment
 124 surveys returned by participants
 8 questions about their OMT practice following attendance
at training
100
90
80
I am more confident in providing an OMT
service.
70
60
56.20
50
40
33.06
30
20
10
6.61
3.31
0.83
0
Strongly disagree
Disagree
Neutral
Agree
Strongly agree
100
90
80
I feel that I am providing a better and
safer OMT service
70
58.12
60
50
40
30
26.50
20
12.82
10
0.00
2.56
0
Strongly disagree
Disagree
Neutral
Agree
Strongly agree
100
90
80
70
I have made fewer OMT dispensing errors
than in the same period of time before the
training.
60
48.57
50
40
28.57
30
20
10
6.67
9.52
6.67
0
Strongly disagree
Disagree
Neutral
Agree
Strongly agree
 Do you support mandatory training for pharmacists who
provide OMT in the ACT?
 121 responses
 Yes = 117
 No = 2
 Other = 2 (conditional support…)
Implications
 This model of training could be readily adopted by
other jurisdictions to address issues of limited
training access and to improve inter-professional
collaboration, and thereby potentially improve
treatment outcomes
Conclusion
 Adoption of targeted opportunistic multi-disciplinary
team training in the treatment of opioid dependence can
increase training accessibility and inter-professional
collaboration