Jeffrey Bratberg

Jeffrey Bratberg
University of Rhode Island | URI · Department of Pharmacy Practice

PharmD

About

91
Publications
7,739
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1,085
Citations
Citations since 2016
67 Research Items
1010 Citations
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2016201720182019202020212022050100150200250

Publications

Publications (91)
Article
Access to the opioid antidote naloxone is a critical component of addressing the opioid crisis. Naloxone is a population-level prevention intervention associated with substantial reductions in overdose mortality and reduction of nonfatal overdose. Pharmacies' pivotal role in dispensing medications like buprenorphine for the treatment of opioid use...
Article
Full-text available
Opioid use disorder (OUD) is a chronic disease requiring long-term treatment and is associated with opioid overdose and increased risk of mortality. However, existing randomized clinical trials focused on short-term treatment engagement and detoxification rather than overdose or mortality risk due to limited follow-up time and ethical consideration...
Article
Background We report on efforts to measure readiness to adopt opioid safety initiatives in community pharmacies within two large chains. Prior studies identified lack of knowledge, confidence, or enthusiasm in addressing harm reduction efforts. We implemented an intervention that provided training to improve opioid safety. The goal was to increase...
Article
Background COVID-19 lockdowns disrupted access to harm reduction supplies and services known to be effective in overdose prevention and contributed to a worsening of the opioid crisis. However, because pharmacies can provide naloxone and sell over-the-counter (OTC) sterile syringes, their continued operation throughout the pandemic potentially rein...
Article
Background and Aims Partial opioid agonist medications for opioid use disorder reduce mortality and morbidity, however long-term retention in treatment is challenging. The objective of this study was to identify patient and prescription characteristics associated with long-term buprenorphine treatment retention. Methods We used data from the Rhode...
Article
Background: Novel educational efforts are needed to prepare the current and future interprofessional health care workforce to address the range of substance use–related health problems. A 6-module massive open online course (MOOC) was developed to provide education to health professionals of various disciplines on the fundamentals of substance use–...
Article
Full-text available
Buprenorphine is a partial μ‐opioid agonist with high receptor binding affinity and long half-life—qualities that reduce overdose risk with concomitant opioid use, though may precipitate withdrawal by displacing full agonists. Traditional buprenorphine induction typically requires patients endure moderate withdrawal prior to initiation, with challe...
Article
Routinely‐collected health data can be employed to emulate a target trial when randomized trial data are not available. Patients within provider‐based clusters likely exert and share influence on each other's treatment preferences and subsequent health outcomes and this is known as dissemination or spillover. Extending a framework to replicate an i...
Article
Background: HIV clinicians are uniquely positioned to treat their patients with opioid use disorder (OUD) using buprenorphine to prevent overdose death. The Prescribe to Save Lives (PtSL) study aimed to increase HIV clinicians' buprenorphine prescribing via an overdose prevention intervention. Methods: The quasi-experimental stepped wedge study...
Article
Background Sexually transmitted infections (STIs) in the United States are at an all-time high. Expedited partner therapy (EPT) has been endorsed by the Centers for Disease Control and Prevention (CDC) to prevent reinfection of patients and their partners. Although this practice is permissible in 46 states, including all of New England and New York...
Preprint
Full-text available
Routinely-collected health data can be employed to emulate a target trial when randomized trial data are not available. Patients within provider-based clusters likely exert and share influence on each other's treatment preferences and subsequent health outcomes and this is known as dissemination or spillover. Extending a framework to replicate an i...
Article
Background As the death toll continues to rise in the opioid overdose epidemic, increasing access to medications for opioid use disorder (OUD), such as buprenorphine, is vital. Psychiatric clinical pharmacist practitioners (CPP) can help bridge the gap in care but are limited in their ability to prescribe buprenorphine given federal restrictions....
Article
Objective: To understand adolescent substance use and its known risk factors at the local and state level; to inform the development of future programs to reduce substance misuse among adolescents. Methods: Survey data collected from a convenience sample of Rhode Island 9th-grade students prior to administration of the RAMS curriculum in 2016 an...
Article
Full-text available
Background The US overdose crisis is driven by fentanyl, heroin, and prescription opioids. One evidence-based policy response has been to broaden naloxone distribution, but how much naloxone a community would need to reduce the incidence of fatal overdose is unclear. We aimed to estimate state-level US naloxone need in 2017 across three main naloxo...
Article
Full-text available
Objective To identify initial diagnoses associated with elevated risk of chronic prescription opioid use. Design Population-based, retrospective cohort study. Setting State of Rhode Island. Participants Rhode Island residents with an initial opioid prescription dispensed between 1 April 2019 and 31 March 2020. Primary outcome measure Subsequent...
Article
Full-text available
BACKGROUND: Benzodiazepines are indicated for the treatment of many conditions, such as anxiety disorders, muscle spasms, alcohol withdrawal, agitation, movement disorders, and epilepsy, and are one of the most frequently prescribed medication classes. This class of medication has important safety considerations, including an increased risk of depe...
Preprint
Full-text available
Background Buprenorphine is a partial µ-opioid agonist with high receptor binding affinity and long half-life—qualities that reduce overdose risk with concomitant opioid use, though may precipitate withdrawal by displacing full agonists. Traditional buprenorphine induction typically requires patients endure moderate withdrawal prior to initiation,...
Article
Background Although the effectiveness of buprenorphine-naloxone (BUP-NX) has been established, real-world evidence on the benefits of early treatment initiation is limited. Objective To evaluate the association between early BUP-NX initiation and health-related outcomes among insured adults with opioid use disorder (OUD). Methods We conducted a c...
Article
Background Access to naloxone is a primary public health strategy to prevent opioid overdose death. Factors associated with primary medication nonadherence (PMN) to naloxone are under-reported in the literature. Objective The objective of this study was to evaluate naloxone dispensing trends and PMN in a community pharmacy setting. Methods This r...
Article
Background Successful vaccination against coronavirus 2019 (COVID-19) is an essential component of achieving community immunity to bring the COVID-19 pandemic to an end. Vaccine hesitancy, identified as a top threat to global health by the World Health Organization, is a significant barrier to vaccine uptake. With COVID-19 vaccination programs in e...
Article
Full-text available
Background The role pharmacies play in addressing the opioid crisis and drug-related risks like injection drug use is evolving. Estimating the prevalence of injection drug use at the community level is challenging due to the stigma of drug use. Many community pharmacies sell non-prescription sterile syringes, thus pharmacy-level sales of injection...
Article
Recognizing that racism has profound effects on persons who use alcohol and other drugs, the Association for Multidisciplinary Education and Research in Substance use and Addiction (AMERSA) commits to promoting equity and inclusion to dismantle the individual, institutional, and structural racism that has pervaded the United States for centuries. R...
Article
Full-text available
The opioid crisis represents one of the largest failures of our current health care system as it continues to claim lives at an unprecedented rate and has caused a devastating range of preventable morbidity. Although the availability of highly potent synthetic opioids has amplified the urgency of the crisis for patients and communities, this proble...
Article
Full-text available
Objective: To estimate the prevalence of concurrent prescription opioid and non-opioid controlled substance use in Rhode Island (RI). Methods: We conducted a cross sectional observational study using data from the RI Prescription Drug Monitoring Program on controlled substance prescriptions dispensed in 2018. We estimated the prevalence of concu...
Article
Background Testing is a principle component to reopening society and bringing the coronavirus 2019 (COVID-19) pandemic to an end. Pharmacists have the ability to perform certain point-of-care tests under federal regulations. On April 8, 2020, the Office of the Assistant Secretary for Health issued new guidance authorizing licensed pharmacists to or...
Article
Full-text available
Background A minority of patients with opioid use disorder are treated for hepatitis C virus infection (HCV). While colocated HCV and opioid agonist therapy (OAT) along with harm reduction can facilitate prevention and cascade to cure, there are few real-world examples of such embedded care models in the United States in the direct-acting antiviral...
Article
Objective: To examine the association between initial patterns of prescription opioid supply (POS) and risk of all-cause mortality among an insured opioid-naïve patient population in the United States (US). Methods: This retrospective observational cohort study used de-identified, administrative health care claims data from a large national insu...
Article
Full-text available
Community pharmacists assist patients to manage disease and prevent complications. Despite the enormous challenge the coronavirus disease 2019 (COVID-19) pandemic has dealt to the health care system, community pharmacists have maintained the delivery of critical health services to communities, including those most at risk for COVID-19. Community ph...
Article
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Introduction: Federal agencies and national associations have implemented action plans in response to the opioid crisis. Furthermore, over 30 states have enacted legislation with opioid-related restrictions, guidance, or requirements. Following recommendations from the governor-appointed Overdose Prevention and Intervention Task Force, the Rhode I...
Article
Hepatitis C virus (HCV) is disproportionately prevalent among different groups of marginalized populations in Rhode Island (RI). Although direct-acting antiviral (DAA) agents are safe and cure HCV, RI payers limit access to these life-saving medications using prior authorizations (PAs). We assessed RI DAA-specific PA criteria. The authors reviewed...
Article
The Rx (prescription) for Addiction and Medication Safety (RAMS) program was developed during the 2017 through 2018 academic year to educate students from 6 selected Rhode Island public high schools about opioid misuse, overdose, and recovery. During 2016, 3 schools participated in the RAMS program and returned for RAMS-PEER in 2017; 3 schools were...
Article
Objectives. To examine early impacts of laws that require naloxone to be prescribed to patients at increased overdose risk. Methods. Using data from 2014 to 2018 from a large pharmacy chain, CVS Pharmacy, we examined the effects of naloxone-prescribing mandates 90 days before and after they took effect in Arizona, Florida, Rhode Island, Vermont, an...
Article
We highlight the critical roles that pharmacists have related to sustaining and advancing the changes being made in the face of the current COVID-19 pandemic to ensure that patients have more seamless and less complex access to treatment. Discussed herein is how the current COVID-19 pandemic is impacting persons with substance use disorders, barrie...
Article
Objectives Pharmacies provide accessible sources of naloxone to caregivers, patients taking opioids, and individuals using drugs. While laws permit expanded pharmacy naloxone access, prior work identified barriers like concerns about stigma of addiction and time constraints that inhibit scale-up. We sought to examine similarities and differences in...
Article
Full-text available
Background: Opioid overdose is a preventable injury leading to high morbidity and premature mortality in communities across the United States. Overdoses take place where people use drugs, including commercial and public locations like community pharmacies, and necessitate swift detection and response to avoid harm and, even more seriously, death....
Article
Background: Naloxone is an antidote to opioid overdose, and community pharmacies nationwide now provide broad access to this medication. Objective: The aim of this qualitative study was to understand how leaders in pharmacy organizations perceive pharmacies and pharmacy staff can optimize dispensing of naloxone. Methods: In-depth interviews we...
Article
Full-text available
Across all care environments, pharmacists play an essential role in the care of people who use and misuse psychoactive substances, including those diagnosed with substance use disorders. To optimize, sustain, and expand these independent and collaborative roles, the Association for Multidisciplinary Education and Research in Substance Use and Addic...
Article
Objective: The aim of this study was to evaluate pharmacist attitudes regarding recommending pharmacy-based naloxone (PBN). The influence of gender, practice setting, the number of years of practice, state, and PBN involvement were explored. Barriers to, and facilitators of, provision of PBN were also assessed. Design: A 71-question survey was d...
Article
Background: Pharmacies are the most accessible healthcare settings across urban, suburban, and rural areas of the United States and, thus a key venue in the overdose risk environment. Pharmacy dispensing of naloxone is part of the public health response to the opioid overdose crisis, yet little is known about the pharmacy- and community-level char...
Article
Purpose: The authors conducted this scoping review to (1) provide a comprehensive evaluation and summation of published literature reporting on interprofessional substance use disorder (SUD) education for students in health professions education programs and (2) appraise the research quality and outcomes of interprofessional SUD education studies....
Article
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Objectives: There is limited research on the attitudes of pharmacy technicians toward pharmacy naloxone provision, despite their widespread role in the pharmacy. We examined attitudes and perceptions of pharmacy technicians in the provision of naloxone in a sample of Massachusetts pharmacies. Design: Thirty-nine community retail pharmacies from...
Article
Nearly 2.5 million Americans have an opioid use disorder (OUD) related to prescription and/or illicit opioids. Pharmacists, as one of the most accessible care providers, are essential in mitigating the mortality and morbidity of the opioid overdose crisis. Pharmacists are involved in numerous care activities related to this crisis and to caring for...
Article
Objective: Our objective was to identify patterns of opioid use among pregnant women enrolled in RI Medicaid. Methods: This study used linked RI Medicaid and RI Birth Certificate data from 01/01/2006 to 12/31/2016. We examined temporal trends of prescription opioid dispensings and identified risk factors associated with opioids use during pregna...
Article
Drug overdose is the leading cause of unintentional death in the USA and the majority of deaths involve an opioid. Pharmacies are playing an increasingly important role in getting naloxone—the antidote to an opioid overdose—into the community. The aim of the current study was to understand, from the perspective of those who had obtained naloxone at...
Article
Background: Rhode Island (RI) ninth graders report lifetime nonmedical use of prescription opioids (NMUPO) of 8.9%. NMUPO is associated with transition to heroin use, opioid overdose, and death. Objectives: Measure changes in 9th grade students' knowledge, confidence, perceptions of opioid use disorder prevention, overdose response with naloxone...
Article
Background: Overdose education and naloxone training was recently implemented into the required curriculum of the College of Pharmacy at the University of Rhode Island. The objective of this study was to compare the retention of knowledge between student pharmacists who received a didactic lecture only versus student pharmacists who received the sa...
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Full-text available
[Full article available at http://rimed.org/rimedicaljournal-2017-10.asp].
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Based on the growing importance of community engagement and the recognition of its importance by the American Association of Colleges of Pharmacy (AACP), the committee offers several examples of community engagement activities for consideration and replication by our academy and beyond. These activities, including those of winning institutions of t...
Article
Objectives: To describe our statewide, pharmacist-led education campaign to increase knowledge and awareness of pneumococcal immunization recommendations. Setting: Immunization providers and residents in the state of Rhode Island. Practice description: A clinical pathway (i.e., decision-support tool) was developed to educate health professiona...
Data
A. Patient Provider Panel Materials.docx B. Naloxone Training Session Materials.docx C. How to Use the VA Intranasal Naloxone Kit.mp4 D. Standardized Patient Activity SP Case Guide.docx E. Standardized Patient Activity Faculty Facilitation Guide.docx F. Standardized Patient Activity Rubric.docx G. Case Study Session Faculty.docx H. Case Study Sessi...
Article
Full-text available
Objectives: Little is known about attitudes of pharmacists and consumers to pharmacy naloxone. We examined perceptions and experiences of pharmacy naloxone from people with opioid use disorder, patients taking chronic opioids for pain, caregivers of opioid users, and pharmacists from 2 early pharmacy naloxone adopter states: Massachusetts and Rhod...
Article
Objective: To implement and evaluate an interprofessional workshop focused on increasing student knowledge, skills, and attitudes toward opioid misuse. Setting: The Warren Alpert Medical School of Brown University in Providence, Rhode Island, April 2016. Practice description: Health professional students from medicine, nursing, pharmacy, socia...
Technical Report
Full-text available
On August 4, 2015, Rhode Island Governor Gina Raimondo issued Executive Order 15-14 to establish a broadly representative Overdose Prevention and Intervention Task Force. This task force developed a strategic plan, which puts forth the most impactful initiatives in the areas of prevention of opioid addiction, reversal of opioid overdose, treatment...
Article
Full-text available
In March of 2015, the United States Department of Health and Human Services identified 3 priority areas to reduce opioid use disorders and overdose, which are as follows: opioid-prescribing practices; expanded use and distribution of naloxone; and expansion of medication-assisted treatment. In this narrative review of overdose prevention and the ro...
Article
Objective. To describe the implementation and effect of an emergency preparedness laboratory activity on student knowledge, willingness to participate in emergency preparedness training, current level of preparedness, and the importance of a pharmacist’s role in disaster response. Design. Second-year pharmacy students in the infectious disease modu...
Article
Full-text available
Introduction Rates of substance use disorders, including opioid misuse, continue to rise despite national initiatives. Because of this, health professional schools from Rhode Island joined together to design and implement a single-day interprofessional education workshop on substance use disorder training. Methods This workshop consists of four se...
Article
Full-text available
The leading cause of adult injury death in the USA is drug overdose, the majority of which involves prescription opioid medications. Outside of the USA, deaths by drug overdose are also on the rise, and overdose is a leading cause of death for drug users. Reducing overdose risk while maintaining access to prescription opioids when medically indicat...
Article
Objective: To assess student pharmacists' perspectives on the curricular timing of the American Pharmacists Association (APhA) Pharmacy-Based Immunization Program and their confidence in providing immunization services. Methods: First (P1) and third (P3) professional year students were required to complete the APhA Immunization Certification. An In...
Article
The number of opioid overdose events in Rhode Island has increased dramatically/catastrophically in the last decade; Rhode Island now has one of the highest per capita overdose death rates in the country. Healthcare professionals have an important role to play in the reduction of unintentional opioid overdose events. This article explores the medic...
Article
Full-text available
In the wake of new recommendations to offer HIV screening to everyone aged 13-64 years and to start all people living with HIV/AIDS on highly active antiretroviral therapy (HAART) regardless of CD4 count, the need to generate widespread, scalable HIV screening programs is greater than ever. Nearly 50,000 new HIV infections occur in the United State...
Article
Objectives To enhance public access to prophylaxis for Lyme disease following an identifiedIxodes scapularis tick bite through pharmacist-initiated antibiotic therapy and to assess patient satisfaction with the pharmacy-based service provided. Setting Independent community pharmacy in Charlestown, RI, from May to October 2012. Practice descriptio...