Telephone-based opioid overdose education and naloxone distribution (OEND) pharmacy consult clinic

Abstract

Objectives: To implement a telephone-based pharmacy driven clinic and increase access to opioid overdose education and naloxone distribution (OEND) in an effort to reduce opioid mortality across the catchment area of one Department of Veterans Affairs (VA) Medical Center. The project intended to assess the feasibility of telephone-based OEND, which has not been reported in the literature.

Setting: The VA is America's largest integrated healthcare system. The Aleda E. Lutz VA Medical Center located in Saginaw, Michigan (Saginaw VAMC) serves veterans throughout Northern Michigan. Pharmacist at the VA serve veterans' healthcare needs in a variety of roles, from traditional medication dispensing to functioning as prescribers of evidence-based medicine. The VA is among the first large health systems to adopt and implement OEND.

Practice innovation: Public health organizations recommend increasing access to naloxone as a key strategy to address the opioid overdose epidemic. Providing lay-persons with naloxone kits is a new concept for patients with long-term opioid therapy. There are no practice models published regarding pharmacy driven telephone-based OEND programs in any setting. A telephone-based OEND consult clinic was created to improve OEND access.

Evaluation: The success of the Clinic was measured by the number of Clinic consults, and a comparison of local naloxone distribution numbers pre- and post-implementation.

Result: The Clinic received 326 consults and 232 were completed January through March of 2017. In calendar-year 2016, 14 naloxone kits were distributed each month on average, whereas 77 naloxone kits on average were released in the first three months of 2017.

Conclusion: Using a combination of printed material and telephone discussion with a pharmacist, the Clinic greatly increased naloxone access in the catchment area. No statistical tests or analysis were performed, however, the clinic dramatically increased the raw number of patients with access to OEND.

Keywords: Naloxone; OEND; Opioid; Overdose; Telephone-Based.