Effect of a pilot care coordination program on compliance with naltrexone extended release suspension for injection

Abstract

Objective: To evaluate the impact of a care coordination pilot program on patient adherence to naltrexone injection for the prevention of opioid and/or ethanol addiction relapse. Methods: This retrospective, nonblinded, pre- and post-intervention observational chart review will test the impact of a care coordination pilot program on outpatient adherence to extended release naltrexone injection for the treatment of opioid and/or ethanol addiction within a community pharmacy setting. The care coordination program will incorporate transition of care as well as substance abuse, emotional, and social support resources. These resources will be provided to the patient at the community pharmacy during their monthly injection as a brochure containing contact information for local support groups, outpatient and counseling programs, employment resources, and substance abuse crisis hotlines. Follow up phone calls, which will assess cravings, potential medication side effects, and support needs will be provided to patients approximately 2 weeks post injection by medical assistants and pharmacists. These medical assistants will receive training on the program's policies and procedures, available resources, and call script by the pharmacy resident. In addition, patients will receive reminder calls prior to scheduled injections and patients who miss their scheduled appointment will receive follow up calls for rescheduling. The study protocol will be submitted to the Investigational Review Board in May 2015. Data collection will commence upon project approval and will occur via chart review of electronic medical records. Demographic data, injection administration dates, proportion of days covered, self-reported opiate/alcohol use, and number of follow up calls will be collected and analyzed using parametric or nonparametric tests as appropriate. The comparison group will be a cohort 6 months prior to the intervention. The pilot program aims to achieve a 15% increase in proportion of days covered.