Implementing an overdose education and naloxone distribution program in a health system

Devries, Jennifer; Rafie, Sally; Polston, Gregory

doi:10.1016/j.japh.2017.01.002

Cited by 62 publications

(86 citation statements)

References 11 publications

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“…After training physicians, pharmacists, and nurses, one study saw the number of prescriptions for naloxone increase from a baseline of 4.5 prescriptions per month to 46 per month during the three-month follow up. 28 Oliva, et al, reported significant uptake in naloxone prescribing, with over 45,000 naloxone prescriptions written by over 5,600 providers to 39,328 patients who were prescribed opioids or who had an opioid use disorder. 29 In addition to being feasible, naloxone prescribing may also be effective at reducing opioid-related adverse events, as Coffin, et al, demonstrated that patients who had received naloxone had 63% fewer opioid-related emergency department visits one year after receiving a naloxone prescription compared to those who did not receive naloxone.…”

Section: Resultsmentioning

confidence: 99%

“…All five studies reported at least some in-person training, while a few studies also reported supplemental electronic 28 or video-based 29 education. Trainings were offered to prescribers in all studies, with some also offering trainings to pharmacists, resident physicians, medical students, and other clinic staff.…”

Section: Resultsmentioning

confidence: 99%

“…Only three studies documented training length, which ranged from 5-60 minutes. 26–28 Two studies described their approach to education as academic detailing. 26,29 Some studies discussed soliciting support from a “clinic champion” to help raise awareness and garner support for naloxone prescribing.…”

Section: Resultsmentioning

confidence: 99%

“…but ultimately also noted that the decision could be based on provider discretion or at a patient’s request. 28,31,32 …”

Section: Resultsmentioning

confidence: 99%

“…30 Some studies also utilized additional clinic staff to conduct education, including pharmacists, medical and pharmacy students, medical assistants, and research associates. Five studies 26,28,29,32,27 offered patients the same or an adapted version of a tri-fold brochure around overdose and naloxone (Appendix 2), while the remaining two used different materials with similar messaging. Four studies 26,30,32, 27 explicitly advised that patients’ caregivers, family members, or friends be included in the naloxone training if possible, though none required that such persons be present.…”

Section: Resultsmentioning

confidence: 99%

See 4 more Smart Citations

Acceptability and feasibility of naloxone prescribing in primary care settings: A systematic review

Behar

Bagnulo

Coffin

2018

Preventive Medicine

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…but ultimately also noted that the decision could be based on provider discretion or at a patient’s request. 28,31,32 …”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Acceptability and feasibility of naloxone prescribing in primary care settings: A systematic review

Behar

Bagnulo

Coffin

2018

Preventive Medicine

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Mobilizing pharmacists to address the opioid crisis: A joint opinion of the ambulatory care and adult medicine practice and research networks of the American College of Clinical Pharmacy

Coon

Hill

Hutchison³

et al. 2020

J Am Coll Clin Pharm

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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 problem has evolved over several decades. Pharmacists are in a position to offer many potential solutions due to their widespread accessibility, extensive drug knowledge, and integration into various health care settings. This opinion paper challenges the status quo by calling on all pharmacists to embrace evidence‐based opioid stewardship and harm reduction practices, contribute to the medical management of opioid use disorder, and address the misconceptions and prejudices that serve as barriers to effective, compassionate patient care. Regardless of practice setting or available resources, pharmacists can take deliberate and impactful steps to address the opioid crisis. Some pharmacists may be positioned to implement innovative and far‐reaching pharmacist‐led clinical services, while others may simply begin with careful consideration of the language they use when speaking to and about patients with substance use disorders. To optimize patient outcomes, the ineffective laws, regulations, and policies that negatively impact pain and addiction care must be addressed so that evidence‐based solutions can be widely disseminated. Pharmacists must aggressively advocate for the removal of barriers preventing high‐level clinical practice or policies that perpetuate patient harm and abandonment. Finally, there must be support for continued research on pain and opioid use disorder treatments and services, as well as the impacts of harm reduction practices and pharmacist‐led clinical services, so that resources can be allocated effectively.

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Role of the pharmacist in acute care interventions for opioid use disorder: A scoping review

Irwin

Walkerly

2021

J Am Coll Clin Pharm

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Opioid use disorder (OUD) is associated with significant morbidity and mortality in the United States. In recent years, interest in initiatives to increase access to medication for OUD (MOUD) and overdose-reversing medications (naloxone) in acute care has grown. While well positioned to intervene, the role of acute care pharmacists in these interventions is not known. The objective for this scoping review was to better understand what is presently known about the role of pharmacists in acute care OUD interventions. These were defined as initiatives implemented in either inpatient or emergency department (ED) settings aimed at treatment of OUD (eg, initiation or management of MOUD) or harm reduction in individuals with OUD (eg, education or targeted naloxone dispensing). PubMed/MEDLINE and Embase databases were searched for articles pertaining to the research question from inception to 19 May 2021. Pearling was performed after the identification of eligible articles. Articles had to explicitly describe the pharmacist's role in planning, implementing, or evaluating an OUD intervention in the inpatient or ED setting.Data charting was performed by both authors using a predefined template, and data synthesis was performed via discussion between authors. The initial title search yielded 101 references which were screened and resulted in four articles that met inclusion criteria. Three additional articles were identified in the pearling process, yielding a total of seven articles. Four described initiatives aimed at point-ofcare dispensing of naloxone, and three described initiatives for provision or management of MOUD. Pharmacist roles primarily consisted of medication use process management, hospital staff and patient education, and dispensing activities. Literature describing the role of pharmacists in acute care OUD interventions is limited.Given the burden of OUD, there are many opportunities for further exploration of the roles acute care pharmacists can play in OUD harm reduction and treatment.

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Implementing an overdose education and naloxone distribution program in a health system

Abstract: Initiating and implementing an overdose education and naloxone distribution program is feasible in an academic health system.

Cited by 62 publications

References 11 publications

Acceptability and feasibility of naloxone prescribing in primary care settings: A systematic review

Acceptability and feasibility of naloxone prescribing in primary care settings: A systematic review

Mobilizing pharmacists to address the opioid crisis: A joint opinion of the ambulatory care and adult medicine practice and research networks of the American College of Clinical Pharmacy

Role of the pharmacist in acute care interventions for opioid use disorder: A scoping review

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