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Group Visits for Overdose Education and Naloxone Distribution in Primary Care: A Pilot Quality Improvement Initiative
Juliette F Spelman1,2, Stephanie Peglow1,2,3, Amy R Schwartz1,2
1Departments of Internal Medicine, VA Connecticut Healthcare System West Haven, CT.
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.
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