• Am J Health Syst Pharm · Mar 2018

    Establishment of a pharmacist-led service for patients at high risk for opioid overdose.

    • Ryan Tewell, Lisa Edgerton, and Elizabeth Kyle.
    • New Hanover Regional Medical Center, Wilmington, NC ryantewell09@gmail.com.
    • Am J Health Syst Pharm. 2018 Mar 15; 75 (6): 376-383.

    PurposeA program at a family medicine clinic to provide naloxone prescriptions in conjunction with education on naloxone use and opioid hazards to patients at risk for opioid overdose is described.SummaryConsistent with a 2016 Centers for Disease Control and Prevention (CDC) guideline on opioid prescribing for chronic pain, a family medicine clinic implemented updated controlled substance agreements and medical record templates for documentation of pain management visits and established a pharmacist-led naloxone clinic. Chart reviews were performed to identify patients eligible for naloxone, as defined by the CDC guideline. A standard visit template was constructed to guide patient education regarding overdose risks and naloxone use. The teach-back method was used to ensure patient understanding, and patients were encouraged to bring a friend or family member to clinic visits. To address medication access barriers, community resources for patient referral for assistance were identified. Barriers to attendance at pharmacist-conducted visits necessitated changes in clinic workflow to incorporate education into prescheduled physician visits and education of some patients via telephone. During the first 6 months of clinic operations, 49 patients were identified as being at risk for opioid overdose; pharmacists educated 84% of those patients and subsequently confirmed that 69% had filled a naloxone prescription.ConclusionNaloxone prescribing and provision of education on naloxone use to at-risk patients in a family medicine clinic can help ensure access to life-saving medication and reinforce CDC recommendations on safe prescribing of opioids.Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

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