Naloxone Outreach Program Incorporating Pharmacy-Based Student Interns

A study incorporating pharmacy student interns into naloxone outreach was found to be feasible, and the program had a high naloxone acceptance rate, according to research published in the Journal of Pain & Palliative Care Pharmacotherapy.

This study was conducted at the William S. Middleton Memorial Veterans Hospital, in Madison, Wisconsin. Incoming third-year pharmacy student interns (n=4) were educated about naloxone and trained to conduct naloxone outreach during their 3-month clinical pharmacy summer internship. The study interns conducted telephone outreach to patients (n=160) who had an established opioid prescription of >50 mg morphine equivalent daily dose or concurrent opioid and benzodiazepine prescriptions. The primary study endpoint was the rate of acceptance of naloxone prescriptions.

During the outreach, the interns provided patients with information about naloxone and offered a prescription. The patients who accepted the prescription were sent a handout in the mail and naloxone was ordered for them. The patients who declined the naloxone prescription were asked about the reasoning for their decision. In the event that the patient did not answer the telephone, the intern would leave a voicemail and reattempt contact the following week. If the patient could not be reached a second time, another voicemail was left, and a handout was sent to them in the mail. Returned calls were routed to the patient-aligned care team clinical pharmacist practitioner.

The majority of study patients were men (90.0% men); the mean age of study participants was 65 years, and the mean morphine equivalent daily dose was 85 mg.

On the first attempt, 118 patients were reached by telephone and 92 accepted naloxone. Among the 42 who were not reached on the first attempt, 32 were mailed a handout after the second failed contact.

The 26 patients who declined naloxone indicated they felt it was unnecessary (n=20), they no longer used their opioids (n=5), or they already had naloxone (n=1).

The average telephone call for a successful contact was 4 minutes and 51 seconds.

Interns who conducted the telephone calls said they were satisfied with the program and were happy with direct patient interactions and with providing a safety tool. They suggested that the training process could be improved by using computers during the training session and having more hands-on practice with documentation and the naloxone ordering process.

A major limitation of this study was the single-center design. It remains unclear whether the findings of this program may be generalizable to other sites.

This study found that an outreach program to educate and order naloxone for patients with an opioid prescription conducted by third-year pharmacy student interns was feasible and successful. The investigators concluded, “The findings of this program highlight the important role of the pharmacy profession in naloxone education and distribution, and particularly demonstrate that supervised pharmacy student interns can play a significant role in advancing the work of opioid safety.”