TY - JOUR
KW - Analgesics, Opioid/adverse effects
KW - Chronic Pain/drug therapy
KW - Drug Overdose/prevention & control
KW - Humans
KW - naloxone
KW - Narcotic Antagonists
KW - Patient Education as Topic/methods
KW - Patient Satisfaction
KW - Pilot Projects
KW - Primary Health Care/methods
KW - Quality Improvement
KW - Chronic Pain
KW - Harm Reduction
KW - Patient Safety
AU - Juliette F. Spelman
AU - Stephanie Peglow
AU - Amy R. Schwartz
AU - Lucille Burgo-Black
AU - Katelyn McNamara
AU - William C. Becker
A1 - 
AB - 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.
AD - Departments of Internal Medicine, VA Connecticut Healthcare System West Haven, CT.; Department of Internal Medicine, Yale University School of Medicine, New Haven, CT.; Departments of Internal Medicine, VA Connecticut Healthcare System West Haven, CT.; Department of Internal Medicine, Yale University School of Medicine, New Haven, CT.; Department of Psychiatry and Behavioral Medicine, Eastern Virginia Medical School, Norfolk, VA, USA.; Departments of Internal Medicine, VA Connecticut Healthcare System West Haven, CT.; Department of Internal Medicine, Yale University School of Medicine, New Haven, CT.; Departments of Internal Medicine, VA Connecticut Healthcare System West Haven, CT.; Department of Internal Medicine, Yale University School of Medicine, New Haven, CT.; Departments of Internal Medicine, VA Connecticut Healthcare System West Haven, CT.; Departments of Internal Medicine, VA Connecticut Healthcare System West Haven, CT.; Department of Internal Medicine, Yale University School of Medicine, New Haven, CT.
BT - Pain medicine (Malden, Mass.)
C5 - Education & Workforce; Healthcare Disparities; Opioids & Substance Use
CP - 12
CY - England
DO - 10.1093/pm/pnx243
IS - 12
JF - Pain medicine (Malden, Mass.)
LA - eng
M1 - Journal Article
N2 - 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.
PB - American Academy of Pain Medicine. This work is written by US Government employees and is in the public domain in the US
PP - England
PY - 2017
SN - 1526-4637; 1526-2375
SP - 2325
EP - 2330
EP - 
T1 - Group Visits for Overdose Education and Naloxone Distribution in Primary Care: A Pilot Quality Improvement Initiative
T2 - Pain medicine (Malden, Mass.)
TI - Group Visits for Overdose Education and Naloxone Distribution in Primary Care: A Pilot Quality Improvement Initiative
U1 - Education & Workforce; Healthcare Disparities; Opioids & Substance Use
U2 - 29045696
U3 - 10.1093/pm/pnx243
VL - 18
VO - 1526-4637; 1526-2375
Y1 - 2017
Y2 - Dec 1
ER -