Development and implementation of procedures for outpatient naloxone prescribing at a large academic medical center

Zschoche, Juliana; Nesbit, Suzanne; Murtaza, Umbreen; Sowell, Amanda; Waldfogel, Julie M.; Arwood, Nicole M.; Rush, Jordan; McNamara, LeAnn; Swarthout, Meghan; Nesbit, Todd; Ortmann, Melinda J.

doi:10.2146/ajhp170759

Cited by 21 publications

(22 citation statements)

References 18 publications

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“…On the inpatient side, pharmacists can serve as leaders in developing strategies to promote education and proper prescribing. For example, pharmacists at The Johns Hopkins Hospital created patient education materials and provided education sessions with patients [13]. Additionally, the establishment of a pharmacist-led naloxone clinic in North Carolina led to 84% of at-risk patients being educated on naloxone and 69% of those patients filling their naloxone prescription, demonstrating the positive impact pharmacy presence can have in primary care efforts against opioid overdoses [11].…”

Section: Discussionmentioning

confidence: 99%

The Prescribing and Education of Naloxone in a Large Academic Medical Center

2020

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The opioid epidemic has led to increased needs for opioid reversal agents which require education and counseling for proper use. The purpose of this study was to evaluate outpatient naloxone prescribing and education practices at an academic medical center to understand the current state and inform quality improvement measures. This retrospective chart review study included 439 patients that were at least 18 years old and received an outpatient prescription for naloxone between 1 July 2017 and 30 June 2018. Descriptive and demographic data were collected. The primary endpoint was whether an indication for naloxone and education on administration were documented when naloxone was initially prescribed to patients. Overall, 39% of naloxone prescriptions did not have an indication for prescribing listed in the medical record. Of those with a documented indication, concomitant benzodiazepines and history of overdose or substance abuse were most common (22% and 14%). The average morphine milligram equivalents were 165. Additionally, 69% of dispenses did not have documentation that the patient or a caregiver received education regarding the use and administration of naloxone. These findings suggest that patients are receiving naloxone for appropriate indications. Documentation of medication education is needed to ensure it is occurring and that patients are informed.

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Section: Discussionmentioning

confidence: 99%

The Prescribing and Education of Naloxone in a Large Academic Medical Center

2020

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“…9 In one working group, clinical pharmacists and pharmacist administrators collaborated with doctors and nursing staff leaders to identify high-risk patient populations and facilitate the prescribing and dispensing of naloxone. 10 The presence of an interprofessional healthcare team, namely doctors, pharmacists, nurses, and social workers, resulted in patients showing a preference for a particular healthcare location for their care. 11 The team included various types of professions, with a team that actually collaborated with each other.…”

Section: Partnershipmentioning

confidence: 99%

“…22 Another form of interprofessional teamwork is the hospital working group reported by Johns Hopkins Hospital that identifies barriers to prescribing outpatient naloxone and to develop and implement policies that consistently outline the approach to prescribing naloxone in an outpatient clinic. 10 Together with primary care providers, pharmacists are directly involved in drug management and procurement, including antiretroviral drugs. 11 Coordination with other healthcare professionals is important because the pharmacist's role often overlaps with that of other healthcare professionals, which sometimes leads to conflicts between team members.…”

Section: Coordinationmentioning

confidence: 99%

“…32 The interprofessional healthcare team also collaborated and coordinated with outpatient pharmacies to enable control of the distribution of naloxone prescriptions. 10 Doctors and pharmacists have cultivated strong relationships to enhance cooperation and increased collaboration regarding treatment management and overall patient management. 20 Interprofessional healthcare teams have provided comprehensive, population-based, patientcentered primary care, 12 and they have worked together to evaluate medicines in patient kits to continuously improve their quality.…”

Section: Cooperationmentioning

confidence: 99%

“… 32 The interprofessional healthcare team also collaborated and coordinated with outpatient pharmacies to enable control of the distribution of naloxone prescriptions. 10 …”

Section: Cooperationmentioning

confidence: 99%

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Role of Pharmacists in the Interprofessional Care Team for Patients with Chronic Diseases

Rahayu¹,

Widianto²,

Defi³

et al. 2021

JMDH

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Chronic diseases are a major health problem and cause of death worldwide. Patients with chronic diseases should be managed by an interprofessional care team consisting of general practitioners, medical specialists, nurses, and pharmacists. However, the roles of pharmacists in this interprofessional care team have not been fully explored. This study, therefore, examined their roles as members of the interprofessional care team in managing patients with chronic diseases. A search in PubMed, Google Scholar, EBSCO, Scopus, and Cochrane Library databases was conducted for research articles that discussed pharmacists, interprofessional healthcare, and chronic diseases. From initial 420 identified articles, a total of 27 articles were included in this study. The interprofessional healthcare team should have a sense of tolerance and belonging among its members, which is reflected in five dimensions: partnership, coordination, cooperation, decision-making, and therapeutic outcomes. The five dimensions are closely related because they support each other in the success of the therapy. The presence of pharmacists in an interprofessional healthcare team has been proven to help facilitate access to primary care and improve patient outcomes. Pharmacists can assist in managing chronic disease conditions by providing drug information to patients and other healthcare providers and by acting as a consultant for treatment-related issues. The pharmacist's role as part of an interprofessional care team reinforces the importance of a collaborative healthcare team in providing clinical services to patients with chronic diseases.

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