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Naloxone access in perinatal substance use disorder
Journal of the American Pharmacists Association : Japha
|February 6, 2024
Summary
Naloxone coprescribing with buprenorphine in perinatal substance use disorder (SUD) clinics was improved through pharmacist-led interventions. Addressing patient and provider barriers is key to achieving 100% naloxone access for pregnant and postpartum individuals with SUD.
Area of Science:
- Pharmacology
- Public Health
- Addiction Medicine
Background:
- Fatal drug overdose risk is elevated in pregnant/postpartum individuals with substance use disorder (SUD).
- Naloxone prescription is recommended for pregnancies with opioid or stimulant use disorder.
Purpose of the Study:
- Assess naloxone coprescribing rates with buprenorphine in a perinatal SUD (PSUD) clinic.
- Identify pharmacist-led interventions to enhance naloxone access and documentation.
- Aim for 100% naloxone coprescribing with buprenorphine in PSUD care.
Main Methods:
- Embedded clinical pharmacist practitioner in an integrated outpatient SUD and perinatal care clinic.
- Assessed baseline naloxone coprescribing rates.
- Implemented provider education, EHR templates, and patient outreach interventions.
Main Results:
- All interventions increased naloxone coprescribing rates in the PSUD clinic.
- EHR documentation templates showed significant impact on initial efforts.
- Pharmacist time investment was substantial for overcoming patient access barriers.
Conclusions:
- Further process improvements are needed to address patient and provider barriers to naloxone access.
- Proactive patient identification and "meds-to-beds" programs may improve naloxone navigation.
- Sustained pharmacist involvement is crucial for optimizing naloxone access in PSUD.
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