Abstract
The SAFE-Home Opioid Management Education (SAFE-HOME) Naloxone Awareness pilot program utilized home health workers (HHWs) in rural settings to educate older adults prescribed opioids on naloxone access and use. This work expands the SAFE-HOME program to urban settings to prepare HHWs to educate community-dwelling older adults on opioid risks and life-saving naloxone. This prospective, interventional cohort study evaluated 60-min synchronous, virtual HHW educational training sessions describing opioid risks in older adults, opioid overdose signs and symptoms, and naloxone access and use. Knowledge assessments were conducted pre- and post-intervention via a pre-developed assessment tool in a repeated measure model. Outcomes included change in total opioid and naloxone knowledge, and baseline total and individual opioid and naloxone knowledge. Six educational sessions were held (n = 154). The average pre- and post-education scores were 62.7% (n = 108) and 83.5% (n = 82), respectively (p < 0.001). Of the 69 participants who completed both pre- and post-education assessments, the average change in total score was +19.6% (p < 0.001), opioid knowledge score −0.4% (p = 0.901), and naloxone knowledge score +32.9% (p < 0.001). At baseline, HHWs were knowledgeable on opioid risks, but lacked familiarity with naloxone access and use. Targeting HHWs with opioid and naloxone training positions them to effectively educate at-risk community-dwelling older adults.
Highlights
Older adults are often overlooked in public health efforts to address the U.S opioid epidemic
Between 2016 and 2017, older adults experienced the largest increase of opioid overdose deaths in any age group (18%) [3]
Participants were recruited from the Senior Services Division of the Catholic Charities Archdiocese of Chicago (CCAC), a community-based organization that provides case coordination and care transition support for older adults, with the primary goal of maintaining independence within the home for as long as possible
Summary
Older adults are nearly three times as likely to be prescribed an opioid than younger populations between 20 and 24 years old [1], potentially due to their increased frequency and severity of chronic pain [2]. Compounded with the higher use of opioids is the increased risk of serious opioid-related adverse effects in older adults which may include confusion, falls, overdose, and death. These serious risks can be exacerbated, since older adults are more likely to be taking interacting medications for other chronic health conditions or have renal or hepatic dysfunction that may increase the amount of opioids in their system [1]. Between 2016 and 2017, older adults experienced the largest increase of opioid overdose deaths in any age group (18%) [3]
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