Administration of buprenorphine depot injection by WA pharmacists

Administration of buprenorphine depot injection by WA pharmacists website image

On 13 September 2023, the WA Government released a new Structured Administration and Supply Arrangement (SASA) that authorises a registered pharmacist trained in the Community Program for Opioid Pharmacotherapy (CPOP) to administer depot buprenorphine when requested by the patient and prescriber.

Checklist before providing this service

Confirm insurance cover PDL continues to support the profession and members in the provision of professional services. For pharmacists considering providing the service, PDL is pleased to state that the PDL Master Policy automatically includes professional indemnity cover for members providing this service in line with the approved guidelines. This is also the case for proprietors who have a Guild Insurance Pharmacy Business Insurance Policy.
Ensure that your pharmacy’s CPOP authorisation is current Confirm that the pharmacy’s trading details are current and appropriate authorisation has been provided to the pharmacy by WA Health to provide depot buprenorphine under the CPOP. The pharmacy will not be able to purchase depot buprenorphine from a wholesaler without this approval. If your pharmacy would like to become involved in delivering CPOP, complete the application form to start the process.
Complete all training required All pharmacists working in CPOP pharmacies (including locums) are required to complete the CPOP Pharmacist Training provided by the Government of Western Australia Mental Health Commission.

Pharmacists registered to provide CPOP services must not administer depot buprenorphine until they have completed the new training module. Pharmacists providing CPOP services who choose not to administer depot buprenorphine are still encouraged to update their knowledge by completing the new training module. The CPOP Pharmacist Training must be repeated at a minimum of every three years. Pharmacists must maintain competency in both technical administration and knowledge of the depot buprenorphine being administered through relevant continuing professional development and recency of practice for administration of injections.

Interns providing depot buprenorphine must be directly supervised in accordance with the Pharmacy Board Guidelines. Both interns and supervising pharmacists must have completed all training required.

Facilities are appropriate to ensure privacy Pharmacists must ensure that the consultation is conducted in an area that protects the patient’s privacy and confidentiality. The location in the pharmacy where administration is being conducted must be appropriately equipped to treat patients in the event of an anaphylactic reaction.
Ensure policies and procedures are in place Ensure that your pharmacy has completed a comprehensive risk assessment and review of the new service to be implemented. Policies and procedures to support workflow, procedures for handling requests appropriately, adequate staffing levels, fees and charges, incident management and referral pathways should be in place and understood by all pharmacy staff.

Ensure that a copy of the ‘Clinical guidelines for use of depot buprenorphine’ is readily available in your pharmacy and has been reviewed by all staff providing the service.

Providing the service

Pre-administration checks Ensure the following details are confirmed prior to dispensing the prescription for depot buprenorphine and preparing for administration:

  • Current treatment plan for the patient is in place with the prescriber and pharmacy that indicates consent to administration by the pharmacist and requirements for communication of dosing issues to the prescriber
  • The original legal prescription for depot buprenorphine has been presented to the pharmacy and clearly indicates the name of the pharmacy where depot buprenorphine is to be administered thereby indicating the prescriber’s intention for the pharmacist to administer depot buprenorphine
  • Review ScriptCheckWA to ensure there are no concerns about the administration of depot buprenorphine
  • Confirm time since previous administration aligns with guidelines
  • Review patient for signs of intoxication
  • Written or documented verbal consent needs to be obtained from the patient prior to each instance of administration
Medicine dispensing

 

Best practice would be to dispense the designated depot buprenorphine on the day of administration to ensure that ScriptCheckWA is accurate. All medications supplied should be dispensed and labelled in accordance with standard dispensing procedures.
Record keeping The pharmacist must keep a clinical record of the consultation and service provision detailing each administration for the patient.
Reporting to the prescriber All dosing issues and adverse events during or after administration of the depot buprenorphine must be reported to the prescriber and where appropriate to the Therapeutic Goods Administration (TGA).

If you have questions regarding this material or the provision of this service, please contact the PDL Professional Officers on 1300 854 838.