Project lifeline: implementing SBIRT in rural pharmacies to address opioid overdoses and substance use disorder

ABSTRACT

Background: There is emerging recognition of the unique benefits of implementing screening, brief intervention, and referral to treatment (SBIRT) in pharmacy settings to identify patients who can benefit from services and connecting them to those services.

Objectives: This study describes Project Lifeline – a multipronged public health initiative to provide educational and technical support to rural community pharmacies implementing SBIRT for substance use disorder (SUD) and providing harm reduction support.

Methods: Eight community pharmacies were recruited. Patients receiving a Schedule II prescription were invited to engage in SBIRT and offered naloxone. Patient screening data and key informant interviews with pharmacy staff on implementation strategy were analyzed.

Results: Between 2018–2020, 4,601 adult patients were offered screens and 3,407 screens were completed on 2,881 unique adult patients (51.3% female; <0.01% nonbinary; 95.7% White). Of these unique screens, 107 patients were indicated for brief intervention, 31 accepted the brief intervention; and 12 were given a referral to SUD treatment. Patients who declined SBIRT or who did not want to reduce their use were offered access to naloxone (n = 372). Key informant interviews highlighted the importance of person-centered staff education, role-playing, anti-stigma training, and integrating activities into existing patient-care processes.

Conclusion: While ongoing research is needed to characterize the full impact of Project Lifeline on patient outcomes, the reported findings help reinforce the benefits of multipronged public health initiatives that include community pharmacists to address the SUD crisis.

KEYWORDS:

• SBIRT
• naloxone
• substance use
• opioid
• community pharmacy
• community pharmacist

Disclosure statement

Joseph Weidman is currently employed by Johnson & Johnson, the majority of his contributions occurred while a student at The University of Pittsburgh and Johnson & Johnson had no role in the study design, collection, analysis or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication.

Within the last 12 calendar months, Dr. Janice Pringle served as a paid consultant for both the C4 Recovery Foundation and the Morehouse School of Medicine. Neither institution played any role in the design nor conduct of the study; collection, management, analysis, nor interpretation of the data; preparation, review, nor approval of the manuscript; nor decision to submit the manuscript for publication. The remaining authors have no conflicts of interest to declare.

Additional information

Funding

This study was funded by the National Association of Chain Drug Stores Foundation. The National Association of Chain Drug Stores Foundation played a role in study design, review of the manuscript, and the decision to submit the paper for publication. The National Association of Chain Drug Stores Foundation did not provide collection, analysis, or interpretation of the data.