UMEM Educational Pearls

Category: Pharmacology & Therapeutics

Title: Barriers to Care: Naloxone

Keywords: naloxone, overdose (PubMed Search)

Posted: 12/3/2018 by Ashley Martinelli (Updated: 12/10/2018)
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Providing naloxone to patients at risk for opioid overdose is now standard of care. A retrospective study evaluated the rate of naloxone obtainment after standardizing the process for prescribing naloxone in the emergency department and dispensing from the hospital outpatient pharmacy. 

55 patients were prescribed naloxone.  Demographics: mean age 48 years old, 75% male, 40% primary diagnosis of heroin diagnosis, 45.5% were prescribed other prescriptions.

Outcomes:

  • 25.5% brought the prescription to the pharmacy
  • 18.2% completed education and obtained naloxone
  • 10% higher rate of success if patient had multiple prescriptions to fill

Barriers identified included lack of ED dispensing program, cost of medication, even though cost is minimal and can be waived, and likely multifactorial reasons why patients did not present to pharmacy as instructed.

Take Home Points:

  • In this complex and challenging patient population, naloxone should be provided
  • Utilize UMMC ED Meds to Beds technicians 1130-1900 M-F to prevent patients from having to travel to pharmacy post-ED visit as this can be a barrier.  The pharmacy technician
  • Prescribe AED To-Go naloxone after hours to improve access to naloxone

 

 

References

Verdier M, Routsolias JC, Aks SE. Naloxone prescriptions from the emergency department: An initiative in evolution. Am J Emerg Med. 2018;37(1)164-165.