Learning Objective: Describe steps used to develop a pharmacist administered long-acting injectable (LAI) program at a health-system community pharmacy
Self- Assessment Question: Which of the following would NOT be a step in starting/expanding a pharmacist administered LAI program in Maryland?
A) Pursuing REMS enrollment for relevant LAI medications
B) Training pharmacists on proper administration of LAI medications
C) Training pharmacy technicians on proper administration of LAI medications
D) Assessing whether pharmacy will be an adequate space to administer LAI medications
Background: Expansion of the LAI antiretroviral (ART) program at a health-system community pharmacy to include antipsychotic and substance use disorder (SUD) LAIs Assess feasibility of LAI program expansion to additional health-system community pharmacies
Methods: This is a quality improvement project that aimed at expanding the current pharmacist administered ART LAI program to include antipsychotic and SUD LAIs. It involved developing and implementing didactic and in-person training for pharmacists, guiding workflow development, and assessing the current health-system community pharmacy for readiness to administer new LAIs. The project also aimed to assess additional community pharmacy sites within the health-system for future expansion of the current pharmacist administered LAI program. This was done by assessing community pharmacies regarding facility readiness, staffing capabilities, inventory, patient and provider needs, and reimbursement considerations.
Results: Three pharmacists who currently administer ART LAIs were trained to administer antipsychotic and SUD LAIs. A comprehensive training plan was finalized and will be available to all community pharmacists without prior LAI experience. The pharmacy utilized for ART LAI administration was found to be suitable for addition of antipsychotic and SUD administration. Updated workflows in the electronic health record are planned; however, system build is in progress. In the meantime, LAIs for antipsychotics and SUD will be administered to initial patients using a temporary workflow. Two other community pharmacies were found to be viable for LAI administration, and a business plan is being developed to outline feasibility of future expansion.
Conclusion: Expansion of the LAI program to include antipsychotics and SUD medications will increase the accessibility of these medications for patients at a health-system community pharmacy. The development of new pharmacist training and plans for comprehensive workflows will ensure a safe and streamlined LAI administration process for pharmacists, providers, and patients. Finally, expansion of LAI program to two additional JHPS sites can occur at a future date.
