Group Visits for Overdose Education and Naloxone Distribution in Primary Care: A Pilot Quality Improvement Initiative

Abstract Objective Opioid prescribing for chronic pain significantly contributes to opioid overdose deaths in the United States. Naloxone as a take-home antidote to opioid overdose is underutilized and has not been evaluated in the high-risk chronic pain population. The objective was to increase ove...

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Bibliographic Details
Published in:Pain medicine (Malden, Mass.) Mass.), 2017-12, Vol.18 (12), p.2325-2330
Main Authors: Spelman, Juliette F, Peglow, Stephanie, Schwartz, Amy R, Burgo-Black, Lucille, McNamara, Katelyn, Becker, William C
Format: Article
Language:English
Subjects:
Analgesics, Opioid - adverse effects
Chronic pain
Chronic Pain - drug therapy
Drug overdose
Drug Overdose - prevention & control
Humans
Morphine
Naloxone
Narcotic Antagonists
Narcotics
Opioids
Overdose
Pain
Patient Education as Topic - methods
Patient Satisfaction
Pilot Projects
Primary care
Primary Health Care - methods
Quality control
Quality Improvement
Risk groups
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Summary:Abstract Objective Opioid prescribing for chronic pain significantly contributes to opioid overdose deaths in the United States. Naloxone as a take-home antidote to opioid overdose is underutilized and has not been evaluated in the high-risk chronic pain population. The objective was to increase overdose education and naloxone distribution (OEND) to high-risk patients on long-term opioid therapy for pain by utilizing group visits in primary care. Design Quality improvement intervention among two primary care clinics. Setting A large, academic facility within the Veterans Health Administration. Subjects Patients prescribed ≥100 mg morphine-equivalent daily dose or coprescribed opioids and benzodiazepines. Methods One clinic provided usual care with respect to OEND; another clinic encouraged attendance at an OEND group visit to all of its high-risk patients. Results We used attendance at group visits, prescriptions of naloxone issued, and patient satisfaction scores to evaluate this format of OEND. Key Results Group OEND visits resulted in significantly more naloxone prescriptions than usual care. At these group visits, patients were engaged, valued the experience, and all requested a prescription for the naloxone kit. Conclusion This quality improvement pilot study suggests that OEND group visits are a promising model of care.
ISSN:1526-2375
1526-4637
DOI:10.1093/pm/pnx243