A Healthcare System-Level Intervention to Increase Naloxone Availability for Patients With Opioid Prescriptions.

Abstract

National guidelines recommend prescribing naloxone to patients receiving chronic opioids. However, provider adherence to naloxone co-prescribing best practices is poor and knowledge gaps for improvement efforts are large. As part of a system-wide quality improvement intervention to improve opioid safety, we sought to improve access to naloxone for patients with opioid prescriptions. A prompt for naloxone co-prescribing was implemented in the electronic health record. Baseline data and data after implementation were collected for naloxone co-prescribing and fill rates on naloxone prescriptions s (n = 9122 pre, 8368 post). In the 9 months following the implementation of the electronic prompt, the total number of naloxone prescriptions increased more than 15-fold. Patients prescribed naloxone filled their naloxone prescriptions similarly (42%) before and after the prompt implementation, resulting in a marked increase in the absolute number of patients with access to naloxone. Patient fill rates varied by clinical area (33% emergency medicine to 47% general medicine). An electronic prompt, encouraging providers to prescribe naloxone to at-risk patients led to a marked increase in the percentage of patients with an active naloxone prescription. The availability of naloxone in communities saves lives and this study is the first to demonstrate an intervention, which led to increased naloxone prescribing and reported on actual pharmacy fills of naloxone when co-prescribed with opioids. (Am J Addict 2020;00:00-00).