Caregiver perceptions toward naloxone for cancer patients at risk of opioid overdose

A knowledge gap persists regarding how patients with cancer requiring opioids and their caregivers perceive a co-prescription of naloxone. This study aims to understand caregivers of cancer patients' perceptions, beliefs, knowledge, and confidence regarding naloxone.

This prospective cross-sectional survey study was conducted at an outpatient palliative and supportive care clinic in a tertiary cancer center in the US between May 2020 and April 2022. Survey questions were based on an in-depth review of previous literature and opioid studies. Patients at risk for opioid overdose received naloxone prescriptions from our team. The survey study examined the proportion of caregivers who perceived a prescription of naloxone benefits the cancer patient and assessed the association between the patients' and caregivers' perceptions. We collected patient demographics and clinical information data. The survey was administered via telephone interview based on the caregivers' availability.

A total of 150 cancer patients and 29 caregivers were included in the analysis. A total of 100/150 (67%) patients and 23/29 (79%) caregivers perceived naloxone as beneficial. Cohen's κ showed fair agreement between the patients and their caregivers (Cohen's κ = 0.34, p = 0.034). A total of 26/29 (89.7%) caregivers felt confident in administering naloxone and calling for help. A total of 29/29 (100%) caregivers agreed that concurrent use of alcohol with pain medications increases risk of overdose.

Cancer patients and caregivers perceived naloxone as beneficial and not likely to cause harm. Agreement between patients and caregivers was only fair, suggesting that better communication regarding naloxone is needed. More research is needed to identify barriers toward safe opioid prescription and increase awareness toward naloxone.