A Pharmacist’s journey: the development of targeted opportunistic multi-disciplinary team training in the

treatment of opioid dependenceKevin ForemanAUA MPS PHCPharmacist Health Professional Level 6Alcohol and Drug ProgramMental Health, Justice Health and Alcohol and Drug ServicesACT Health DirectorateAdjunct Professional AssociateUniversity of Canberra Discipline of Pharmacy

Ben GilbertBPharm GradDipTox GCHE MPS AACPALecturer in PharmacyFaculty of Health, Discipline of PharmacyUniversity of Canberra

Dr R ParigeMD FAChAM MRO(USA)Senior SpecialistAlcohol and Drug ProgramMental Health, Justice Health and Alcohol and Drug ServicesACT Health Directorate

Jill HughesManager of Clinical ServicesAlcohol and Drug ProgramMental Health, Justice Health and Alcohol and Drug ServicesACT Health Directorate

IssueTraining 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

IssueTraining 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

IssuePreviously:

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

IssueIn 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 MinisterThe Guidelines require compulsory training for all

pharmacists to be accredited by ACT Health to dispense opioid maintenance treatment

ApproachThis led to an increased and sustained demand for

training, and prompted the development of targeted opportunistic multidisciplinary training as a novel solution

ApproachTargeted:

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.

ApproachMultidisciplinary:

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 findingsSince June 2010, 519 health professionals have attended

68 training events:415 pharmacists (including students and interns)44 doctors58 nurses2 social workers

ApproachThe 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 activitiesProblem 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 Expiry 14/4/2016 Kevin Foreman Senior Pharmacist

Key findingsThe 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 participants8 questions about their OMT practice following attendance

at training

Strongly disagree

Disagree Neutral Agree Strongly agree0

10

20

30

40

50

60

70

80

90

100

3.310.83

6.61

56.20

33.06

I am more confident in providing an OMT service.

Strongly disagree

Disagree Neutral Agree Strongly agree0

10

20

30

40

50

60

70

80

90

100

0.002.56

12.82

58.12

26.50

I feel that I am providing a better and safer OMT service

Strongly disagree

Disagree Neutral Agree Strongly agree0

10

20

30

40

50

60

70

80

90

100

6.679.52

48.57

28.57

6.67

I have made fewer OMT dispensing errors than in the same period of

time before the training.

Do you support mandatory training for pharmacists who provide OMT in the ACT?

121 responsesYes = 117No = 2Other = 2 (conditional support…)

ImplicationsThis 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

ConclusionAdoption of targeted opportunistic multi-disciplinary

team training in the treatment of opioid dependence can increase training accessibility and inter-professional collaboration