Effects of pharmacist-driven protocol on naloxone prescribing rates in two primary care clinics
The Centers for Disease Control and Prevention (CDC) Guidelines for Prescribing Opioids for Chronic Pain recommend co-prescribing naloxone as a harm reduction strategy when there is an increased risk of opioid overdose. Although naloxone co-prescribing is an important harm reduction strategy, many a...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-12-01
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| Series: | Preventive Medicine Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2211335523003844 |
| _version_ | 1827765221036392448 |
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| author | Ashley Daffron Kelly Koon Nathan P Gruenke Sara Wettergreen |
| author_facet | Ashley Daffron Kelly Koon Nathan P Gruenke Sara Wettergreen |
| author_sort | Ashley Daffron |
| collection | DOAJ |
| description | The Centers for Disease Control and Prevention (CDC) Guidelines for Prescribing Opioids for Chronic Pain recommend co-prescribing naloxone as a harm reduction strategy when there is an increased risk of opioid overdose. Although naloxone co-prescribing is an important harm reduction strategy, many at risk patients are not prescribed naloxone. The objective was to assess the effectiveness of a pharmacist-driven protocol at increasing the number of patients co-prescribed naloxone according to CDC recommendations. The study design was a multi-center retrospective cohort to evaluate the outcomes of a quality improvement intervention at two primary care clinics which aimed to increase naloxone co-prescribing. The intervention used a two-pronged approach consisting of telephonic outreach to eligible patients by pharmacists and pharmacy interns related to naloxone education and recommendations for naloxone co-prescribing. Additionally, recommendations were sent to the primary care provider in the electronic medical record (EMR) for consideration and implementation. After the 3 month intervention, 57 of the 86 patients contacted were co-prescribed naloxone (66.3%). Most naloxone initiation occurred at the time of telephonic outreach as a new medication order (n = 36), however an additional 12 patients were co-prescribed naloxone at a subsequent primary care provider visit. The proportion of patients at each clinic with MME ≥ 50 co-prescribed naloxone significantly increased after implementation of the intervention (pre 25/64 vs. post 43/76, p = 0.043). Overall, telephonic outreach to patients with recommendations to primary care providers in the EMR were effective methods to increase the rate of naloxone co-prescribing in primary care based on this study. |
| first_indexed | 2024-03-11T11:16:03Z |
| format | Article |
| id | doaj.art-f76bd32cc85e4e75a23c85553874e963 |
| institution | Directory Open Access Journal |
| issn | 2211-3355 |
| language | English |
| last_indexed | 2024-03-11T11:16:03Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Preventive Medicine Reports |
| spelling | doaj.art-f76bd32cc85e4e75a23c85553874e9632023-11-11T04:28:01ZengElsevierPreventive Medicine Reports2211-33552023-12-0136102493Effects of pharmacist-driven protocol on naloxone prescribing rates in two primary care clinicsAshley Daffron0Kelly Koon1Nathan P Gruenke2Sara Wettergreen3Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, 12850 E. Montview Blvd, C238 Aurora, CO 80045, United States; Corresponding author.PGY-2 Ambulatory Care Pharmacy Resident, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, 12850 E. Montview Blvd, C238 Aurora, CO 80045, United StatesPharmacy Student, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, 12850 E. Montview Blvd, C238 Aurora, CO 80045, United StatesDepartment of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, 12850 E. Montview Blvd, C238 Aurora, CO 80045, United StatesThe Centers for Disease Control and Prevention (CDC) Guidelines for Prescribing Opioids for Chronic Pain recommend co-prescribing naloxone as a harm reduction strategy when there is an increased risk of opioid overdose. Although naloxone co-prescribing is an important harm reduction strategy, many at risk patients are not prescribed naloxone. The objective was to assess the effectiveness of a pharmacist-driven protocol at increasing the number of patients co-prescribed naloxone according to CDC recommendations. The study design was a multi-center retrospective cohort to evaluate the outcomes of a quality improvement intervention at two primary care clinics which aimed to increase naloxone co-prescribing. The intervention used a two-pronged approach consisting of telephonic outreach to eligible patients by pharmacists and pharmacy interns related to naloxone education and recommendations for naloxone co-prescribing. Additionally, recommendations were sent to the primary care provider in the electronic medical record (EMR) for consideration and implementation. After the 3 month intervention, 57 of the 86 patients contacted were co-prescribed naloxone (66.3%). Most naloxone initiation occurred at the time of telephonic outreach as a new medication order (n = 36), however an additional 12 patients were co-prescribed naloxone at a subsequent primary care provider visit. The proportion of patients at each clinic with MME ≥ 50 co-prescribed naloxone significantly increased after implementation of the intervention (pre 25/64 vs. post 43/76, p = 0.043). Overall, telephonic outreach to patients with recommendations to primary care providers in the EMR were effective methods to increase the rate of naloxone co-prescribing in primary care based on this study.http://www.sciencedirect.com/science/article/pii/S2211335523003844NaloxonePharmacistChronic painOpioidCo-prescribingPrimary care |
| spellingShingle | Ashley Daffron Kelly Koon Nathan P Gruenke Sara Wettergreen Effects of pharmacist-driven protocol on naloxone prescribing rates in two primary care clinics Preventive Medicine Reports Naloxone Pharmacist Chronic pain Opioid Co-prescribing Primary care |
| title | Effects of pharmacist-driven protocol on naloxone prescribing rates in two primary care clinics |
| title_full | Effects of pharmacist-driven protocol on naloxone prescribing rates in two primary care clinics |
| title_fullStr | Effects of pharmacist-driven protocol on naloxone prescribing rates in two primary care clinics |
| title_full_unstemmed | Effects of pharmacist-driven protocol on naloxone prescribing rates in two primary care clinics |
| title_short | Effects of pharmacist-driven protocol on naloxone prescribing rates in two primary care clinics |
| title_sort | effects of pharmacist driven protocol on naloxone prescribing rates in two primary care clinics |
| topic | Naloxone Pharmacist Chronic pain Opioid Co-prescribing Primary care |
| url | http://www.sciencedirect.com/science/article/pii/S2211335523003844 |
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