IntroductionTreatment with medications such as buprenorphine has been shown to improve outcomes of patients with opioid use disorder (OUD); however, there is still potential to optimize care. Clinical pharmacists may benefit OUD patient treatment by making individualized medication recommendations and enhancing care as part of a multidisciplinary team. This study evaluates a novel outpatient practice model that incorporates pharmacists to manage OUD patients.MethodsA multi‐center retrospective study compared outcomes of a multidisciplinary practice with clinical pharmacists to a physician‐only practice. Primary outcomes were treatment retention and opioid relapse rate. Secondary outcomes included patient engagement with counseling, toxicology results, and buprenorphine nonadherence. Data were collected from 75 patient records from each practice for up to 1 year after starting treatment. In addition, a prospective, observational study was conducted to describe pharmacist interventions at the multidisciplinary practice. Twenty patients were followed for up to 1 year to characterize pharmacist recommendations and assess treatment retention and opioid relapse rates among other secondary measures.ResultsIn the retrospective study, treatment retention did not differ between practices (P > .05) but multidisciplinary practice patients experienced fewer opioid relapse months (P < .05). Similar rates of engagement with counseling (P = 1) and follow‐up visits with illicit substance use (P > .05) were observed. More buprenorphine nonadherence was identified at the physician practice (P < .01). In the prospective study, pharmacist recommendations included buprenorphine regimen changes and the addition of new medications for un/undertreated conditions. Pharmacists provided care coordination, medication counseling, non‐pharmacologic recommendations, and counseling regarding future/alternative treatment options.ConclusionThis study demonstrates the ability of a practice with clinical pharmacists to provide quality care to OUD patients in an outpatient setting. These results have implications for OUD treatment by expanding addiction services in this underserved patient population.

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Background Patients diagnosed as having multiple sclerosis (MS) experience a wide range of symptoms requiring pharmacologic management, and many do not achieve adequate symptom control. The purpose of this study was to evaluate the role of medical cannabis (MC) as part of a comprehensive treatment plan for patients with MS. Methods A retrospective medical record review of 141 patients with MS receiving MC for symptom management was conducted. Data were collected for up to 4 follow-up appointments after initiation of MC. Outcomes included changes in MS symptoms, medication changes, adverse events, and changes in cognition and mobility. Results Patients experienced extensive MS symptom improvement after initiation of MC, with alleviation of pain (72% of patients) and spasticity (48% of patients) and improvement in sleep (40% of patients) the most common. There was a significant reduction in concomitant opioid use after initiating MC as evidenced by a significant decrease in daily morphine milligram equivalents among patients prescribed opioid analgesics (P = .01). Decreases in muscle relaxant use and benzodiazepine use did not reach significance (P &gt; .05). The most common adverse reaction to MC was fatigue (11% of patients). Conclusions In many patients with MS, MC was well-tolerated, eased pain and spasticity, improved sleep and other symptoms, and reduced use of concomitant opioid analgesics. Prospective studies are needed to further investigate the role of MC in the treatment of patients with MS.