Leveraging Pharmacists to Expand Access to Care Kicks off AAPP 2023

Sarah Popish, PharmD, BCPP
AAPP Recertification Editorial Board Member
Academic Educator
Department of Veterans Affairs
Vallejo, CA

The COVID-19 pandemic has had many impacts on people with mental health and substance use conditions.¹ Infection control has affected how mental health and substance use disorder care is delivered. Many strategies were developed to meet the new needs, including telehealth and digital tools like apps and websites for therapy.^1,2 This shift to telemedicine appears to be welcomed and will likely outlast the pandemic. However, many fear it potentially negatively impacts rapport and therapeutic relationships, and it only meets the needs of individuals with the access and expertise necessary to use the technology.^1,3 Determining when and where to continue utilizing this and other innovations developed during the pandemic is needed.

The impact of the pandemic goes beyond the need to find innovative ways to provide care. According to a survey released by the American Psychological Association (APA), over one-third of Americans (36%) who were surveyed reported that the coronavirus has a “serious impact” on their mental health.⁴ The pandemic did not only exacerbate mental health issues. It also affected individuals with no history of mental health conditions,⁵ leading to increased demand for mental health care.^1,2,6 This highlights the need to expand services for those with mental health disorders.

Compounding concerns, the Centers for Disease Control and Prevention (CDC) reported over 100,000 drug overdose deaths in the US in 12 months ending in April 2021, the highest ever recorded.⁷ In addition, in 2020, the frequency of alcohol use increased by 14% compared to the 2019 baseline.⁸ There is limited access to SUD care nationwide, with notable deficiencies in rural settings, and the pandemic has further exacerbated access to care.^3,9 This underscores the need to expand SUD prevention, response, treatment, and harm reduction.

The Recertification Editorial Board is excited to have, Tera D. Moore, PharmD, BCACP, and Veldana Alliu, PharmD lead Monday's keynote address at AAPP 2023. They will provide information on innovative and emerging opportunities utilized to expand access to mental health and substance use disorder care, outline strategies to remove barriers to care delivery by pharmacists, and highlight best practices and treatment standards for these disorders that have been applied during the pandemic.

Learning Objectives:

1. Assess how the COVID-19 pandemic impacted mental health/substance use disorder treatment standards and best practices.
2. Evaluate innovations implemented during the COVID-19 pandemic to improve access to mental health/ substance use disorder care during a time of crisis.
3. Propose collaborative practice models that integrate pharmacist practitioners and enhance access to mental health/substance use disorder care.

Tera Moore, Pharm.D., BCACP has served the VA for over 19 years and is the National Program Manager for Clinical Practice Integration and Model Advancement with the Department of Veterans Affairs Pharmacy Benefits Management Services, Clinical Pharmacy Practice Office (CPPO). In this role, Dr. Moore develops and manages initiatives that aid in demonstrating the value and criticality of advancing clinical pharmacy practice across VA facilities. She particularly emphasizes program development, implementation, and outcomes assessments focused on Mental Health, Suicide Prevention, Substance Use Disorders, and Neurology. Dr. Moore is a past recipient of the Certificate of Commitment from the VHA Acting Deputy Undersecretary for Patient Care Services, the VHA Under Secretary for Health Pharmacy Benefits Management Innovation Award, and the PBM CPPO was awarded the ASHP Board of Director’s Award of Excellence. She has given multiple presentations reflecting her clinical pharmacy practice and leadership expertise. She also has authored several peer-reviewed publications.

Dr. Veldana Alliu is a National Pharmacy Program Manager for Clinical Practice Integration and Model Advancement with the Veteran Health Administration (VHA) Pharmacy Benefits Management (PBM) Clinical Pharmacy Practice Office (CPPO). In her current role, Dr. Alliu serves as a national pharmacy subject matter expert supporting clinical pharmacy practice in Substance Use Disorders. Her role includes spearheading optimization, integration, and standardization of Clinical Pharmacist Practitioners (CPPs) in direct patient care roles to improve Veteran access to comprehensive medication management services. She is actively involved in the American Society of Health-System Pharmacists (ASHP) and the Florida Society of Health-System Pharmacists (FSHP). Dr. Alliu has worked for the VA for over ten years as a Clinical Pharmacist Practitioner and Clinical Pharmacy Leader before joining CPPO in 2019.

References

1. Sheridan Rains L, Johnson S, Barnett P, et al. Early impacts of the COVID-19 pandemic on mental health care and on people with mental health conditions: framework synthesis of international experiences and responses. Soc Psychiatry Psychiatr Epidemiol. 2021;56(1):13-24.
2. Masand P, Patkar A, Tew C, Hoerner A, Szabo ST, Gupta S. Mental Health and COVID-19: Challenges and Multimodal Clinical Solutions. J Psychiatr Pract. 2021;27(4):254-264.
3. López-Pelayo H, Aubin HJ, Drummond C, et al. "The post-COVID era": challenges in the treatment of substance use disorder (SUD) after the pandemic. BMC Med. 2020;18(1):241.
4. American Psychiatric Association. March 25, 2020. New poll: COVID-19 impacting mental well-being: Americans feeling anxious, especially for loved ones; older adults are less anxious. Available at: https://www.psychiatry.org/newsroom/news-releases/new-poll-covid-19-impacting-mental-well-being-americans-feeling-anxious-especially-for-loved-ones-older-adults-are-less-anxious. Accessed Nov 3, 2022.
5. Lindert J, Jakubauskiene M, Bilsen J. The COVID-19 disaster and mental health-assessing, responding and recovering. Eur J Public Health. 2021;31(Supplement_4):iv31-iv35.
6. Petersen A. More people are taking drugs for anxiety and insomnia, and doctors are worried. New York, NY: The Wall Street Journal; 2020. Available at: www.wsj.com/articles/more-people-are-taking-drugs-for-anxiety-and-insomnia-and-doctors-are-worried-11590411600. Accessed Nov, 3 2020. .
7. Centers for Disease Control and Prevention. May 11,2022. U.S. overdose deaths in 2021 increased half as much in 2020- but are still up 15%. Available at: https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2022/202205.htm. Accessed Nov 3, 2022. .
8. Pollard MS, Tucker JS, Green HD, Jr. Changes in Adult Alcohol Use and Consequences During the COVID-19 Pandemic in the US. JAMA Netw Open. 2020;3(9):e2022942.
9. Connery HS, McHugh RK, Reilly M, Shin S, Greenfield SF. Substance Use Disorders in Global Mental Health Delivery: Epidemiology, Treatment Gap, and Implementation of Evidence-Based Treatments. Harv Rev Psychiatry. 2020;28(5):316-327.