TY - JOUR
KW - Adult
KW - Analgesics, Opioid/administration & dosage/adverse effects
KW - Decision Support Systems, Clinical
KW - Drug Overdose/drug therapy/mortality
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Naloxone/administration & dosage/supply & distribution
KW - Narcotic Antagonists/administration & dosage/supply & distribution
KW - Opioid-Related Disorders/complications
KW - Patient Education as Topic/methods
KW - Pharmaceutical Services/organization & administration
KW - Program Development
KW - United States
KW - United States Department of Veterans Affairs
AU - Elizabeth M. Oliva
AU - Melissa L. D. Christopher
AU - Daina Wells
AU - Mark Bounthavong
AU - Michael Harvey
AU - Julianne Himstreet
AU - Thomas Emmendorfer
AU - Michael Valentino
AU - Mariano Franchi
AU - Francine Goodman
AU - Jodie A. Trafton
AU - Veterans Health Administration Opioid Overdose Education and Naloxone Distribution National Support and Development Workgroup
A1 - 
AB - OBJECTIVES: To prevent opioid-related mortality, the Veterans Health Administration (VHA) developed a national Opioid Overdose Education and Naloxone Distribution (OEND) program. SETTING: VHA's OEND program sought national implementation of OEND across all medical facilities (n = 142). PRACTICE DESCRIPTION: This paper describes VHA's efforts to facilitate nationwide health care system-based OEND implementation, including the critical roles of VHA's national pharmacy services and academic detailing services. PRACTICE INNOVATION: VHA is the first large health care system in the United States to implement OEND nationwide. Launching the national program required VHA to translate a primarily community-based public health approach to OEND into a health care system-based approach that distributed naloxone to patients with opioid use disorders as well as to patients prescribed opioid analgesics. Key innovations included developing steps to implement OEND, pharmacy developing standard naloxone rescue kits, adding those kits to the VHA National Formulary, centralizing kit distribution, developing clinical guidance for issuing naloxone kits, and supporting OEND as a focal campaign of academic detailing. Other innovations included the development of patient and provider education resources (e.g., brochures, videos, accredited training) and implementation and evaluation resources (e.g., technical assistance, clinical decision support tools). EVALUATION: Clinical decision support tools that leverage VHA national data are available to clinical staff with appropriate permissions. These tools allow staff and leaders to evaluate OEND implementation and provide actionable next steps to help them identify patients who could benefit from OEND. RESULTS: Through fiscal year 2016, VHA dispensed 45,178 naloxone prescriptions written by 5693 prescribers to 39,328 patients who were primarily prescribed opioids or had opioid use disorder. As of February 2, 2016, there were 172 spontaneously reported opioid overdose reversals with the use of VHA naloxone prescriptions. CONCLUSION: VHA has successfully translated community-based OEND into health care system-based OEND targeting 2 patient populations. There is a tremendous amount that can be learned from VHA's experience implementing this novel health care innovation nationwide.
BT - Journal of the American Pharmacists Association : JAPhA
C5 - Education & Workforce; Healthcare Disparities; Opioids & Substance Use
CP - 2S
CY - United States
DO - 10.1016/j.japh.2017.01.022
IS - 2S
JF - Journal of the American Pharmacists Association : JAPhA
LA - eng
M1 - Journal Article
N2 - OBJECTIVES: To prevent opioid-related mortality, the Veterans Health Administration (VHA) developed a national Opioid Overdose Education and Naloxone Distribution (OEND) program. SETTING: VHA's OEND program sought national implementation of OEND across all medical facilities (n = 142). PRACTICE DESCRIPTION: This paper describes VHA's efforts to facilitate nationwide health care system-based OEND implementation, including the critical roles of VHA's national pharmacy services and academic detailing services. PRACTICE INNOVATION: VHA is the first large health care system in the United States to implement OEND nationwide. Launching the national program required VHA to translate a primarily community-based public health approach to OEND into a health care system-based approach that distributed naloxone to patients with opioid use disorders as well as to patients prescribed opioid analgesics. Key innovations included developing steps to implement OEND, pharmacy developing standard naloxone rescue kits, adding those kits to the VHA National Formulary, centralizing kit distribution, developing clinical guidance for issuing naloxone kits, and supporting OEND as a focal campaign of academic detailing. Other innovations included the development of patient and provider education resources (e.g., brochures, videos, accredited training) and implementation and evaluation resources (e.g., technical assistance, clinical decision support tools). EVALUATION: Clinical decision support tools that leverage VHA national data are available to clinical staff with appropriate permissions. These tools allow staff and leaders to evaluate OEND implementation and provide actionable next steps to help them identify patients who could benefit from OEND. RESULTS: Through fiscal year 2016, VHA dispensed 45,178 naloxone prescriptions written by 5693 prescribers to 39,328 patients who were primarily prescribed opioids or had opioid use disorder. As of February 2, 2016, there were 172 spontaneously reported opioid overdose reversals with the use of VHA naloxone prescriptions. CONCLUSION: VHA has successfully translated community-based OEND into health care system-based OEND targeting 2 patient populations. There is a tremendous amount that can be learned from VHA's experience implementing this novel health care innovation nationwide.
PP - United States
PY - 2017
SN - 1544-3450; 1086-5802
SP - S168
EP - S179.e4
EP - 
T1 - Opioid overdose education and naloxone distribution: Development of the Veterans Health Administration's national program
T2 - Journal of the American Pharmacists Association : JAPhA
TI - Opioid overdose education and naloxone distribution: Development of the Veterans Health Administration's national program
U1 - Education & Workforce; Healthcare Disparities; Opioids & Substance Use
U2 - 28292502
U3 - 10.1016/j.japh.2017.01.022
VL - 57
VO - 1544-3450; 1086-5802
Y1 - 2017
Y2 - Mar - Apr
ER -