Integrated Interdisciplinary Model of Opioid Agonist Treatment (IIMOAT)

Practice Update

Upcoming changes in pharmacy and nursing practice seek to improve patient engagement in and retention on OAT through meeting patients where they are at and reducing the number of places they need visit to obtain health care support, including medication.

In advance of the opioid use disorder (OUD) treatment guideline update, this practice update outlines the responsibilities of the health care professionals involved in the care of people on opioid agonist treatment (OAT) in an interdisciplinary model. It provides detail on the practice changes, key roles and responsibilities, and a suggested workflow to support implementation.

This update outlines a model of care that includes pharmacists, nurses (RN, RPN and LPNs), nurse practitioners, physicians, and nurse prescribers, and applies to all outpatient settings, including ambulatory care and/or outpatient clinics of hospitals; except Corrections.

Key practice changes

For sites that adopt this model, these are some of the key changes in practice to facilitate partnership and shared care between pharmacies and clinics:

  • Nurses can be authorized to provide witnessing and take-home doses of pharmacy-prepared medication when written on the patients’ OAT prescription.
  • Nurses are to document any changes made to pharmacy-prepared patient-specific medication—such as increased doses, decreased doses, or missed doses—on PharmaNet using the transaction medication update (TMU; see below for description) by the end of the clinic day or shift.
  • In cases where the patient needs a dose or a take-home dose (e.g., bupe-to-go induction packages) and the pharmacy is unable to prepare, it can be prepared by nursing and provided through clinic stock. The exceptional reason must be documented and entered in PharmaNet by using the TMU transaction.
Practice Update: IIMOAT
TMU Entry Guidance
TMU Entry Guidance: Clinic (ward) stock used
TMU Entry Guidance: Patient-specific pharmacy-dispensed changes
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