Journal article
Improving Naloxone Co-prescribing Through Clinical Decision Support
Curēus (Palo Alto, CA), Vol.16(7), e63919
07/05/2024
DOI: 10.7759/cureus.63919
PMCID: PMC11298243
PMID: 39099893
Abstract
Background: Despite national guidelines recommending naloxone co-prescription with high-risk medications, rates remain low nationally. This was reflected at our institution with remarkably low naloxone prescribing rates. We sought to determine if a clinical decision support (CDS) tool could increase rates of naloxone co-prescribing with high-risk prescriptions.
Methods: An alert in the electronic health record was triggered upon signing an order for a high-risk opioid medication without a naloxone co-prescription. We examined all opioid prescriptions written by family and general internal medicine practitioners at the University of Iowa Hospitals and Clinics in outpatient encounters between November 30, 2020, and February 28, 2022. Once triggered by a high-risk prescription, the CDS tool had the option to choose an order set with an automatically selected co-prescription for naloxone along with patient instructions automatically added to the patient's after-visit summary (AVS). We examined the monthly percentage of patients receiving Schedule II opioid prescriptions ≥90 morphine milliequivalents (MME)/day who received concurrent naloxone prescriptions in the 12 months before the CDS went live and the three months following go-live.
Results: Concurrent naloxone prescriptions increased from 1.1% in the 12 months prior to implementation in November 2021 to 9.4% (p<0.001) during the post-intervention period across eight family medicine and internal medicine clinics.
Discussion: This single-center quality improvement project with retrospective analysis demonstrates the potential efficacy of a single CDS tool in increasing the rate of naloxone prescription. The impact of such prescribing on overall mortality requires further research.
Conclusions: The CDS tool was easy to implement and improved rates of appropriate naloxone co-prescribing.
Details
- Title: Subtitle
- Improving Naloxone Co-prescribing Through Clinical Decision Support
- Creators
- Elizabeth CramerEthan KupermanNathan MeyerJames Blum
- Resource Type
- Journal article
- Publication Details
- Curēus (Palo Alto, CA), Vol.16(7), e63919
- DOI
- 10.7759/cureus.63919
- PMID
- 39099893
- PMCID
- PMC11298243
- NLM abbreviation
- Cureus
- ISSN
- 2168-8184
- eISSN
- 2168-8184
- Publisher
- SPRINGERNATURE
- Grant note
info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.
- Language
- English
- Date published
- 07/05/2024
- Academic Unit
- Family and Community Medicine; Anesthesia; General Internal Medicine; Internal Medicine
- Record Identifier
- 9984656659302771
Metrics
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