A Pharmacist’s journey: the development of targeted opportunistic multi-disciplinary team training in the treatment of opioid dependence Kevin Foreman 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 Ben Gilbert BPharm GradDipTox GCHE MPS AACPA Lecturer in Pharmacy Faculty of Health, Discipline of Pharmacy University of Canberra Dr R Parige MD FAChAM MRO(USA) Senior Specialist Alcohol and Drug Program Mental Health, Justice Health and Alcohol and Drug Services ACT Health Directorate 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 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 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

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

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