Program evaluation of the Opioid and Naloxone Education (ONE Rx) program using the RE-AIM model

Abstract

Opioid and Naloxone Education (ONE Rx) is a program that focuses on community pharmacy-based patient screening and interventions to improve population health with regard to opioid use. The objective for this paper is to describe how ONE Rx was implemented, report on the populations impact using the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) Model, and explain future implications of the program. ONE Rx is a statewide program in which pharmacists screen patients who receive an opioid prescription for the risk of opioid misuse and accidental overdose. The five domains of the RE-AIM Model were used to evaluate ONE Rx. Reach was defined as the proportion of patients receiving opioid prescriptions who completed the screening. Efficacy was defined as the proportion of individuals identified as at risk of opioid misuse or accidental overdose and who received a pharmacist intervention. Adoption was defined as the proportion of eligible community pharmacies who enrolled in ONE Rx. Implementation was defined as the proportion of pharmacies that enrolled in ONE Rx that provided at least five patient screenings. Maintenance was defined as the proportion of pharmacies that adopted ONE Rx that completed at least one screening three months after the initial provision. Approximately 16.9% of all patients receiving opioid prescriptions were screened for risk of opioid misuse and accidental overdose. Of the patients screened, 97.1% of patients at risk for opioid misuse or accidental overdose received a pharmacist-led intervention. Additionally, 44.8% of the pharmacist that enrolled in ONE Rx completed at least five screenings and of those, 80.0% maintained the program three months later. ONE Rx demonstrated success and positive population impact. The RE-AIM Model identified strength in the areas of efficacy, adoption and maintenance, and the need for improvement in the areas of reach and implementation.