Dataset Information

Naloxone Co-Dispensing with Opioids: a Cluster Randomized Pragmatic Trial.

ABSTRACT:

Background

Although naloxone prevents opioid overdose deaths, few patients prescribed opioids receive naloxone, limiting its effectiveness in real-world settings. Barriers to naloxone prescribing include concerns that naloxone could increase risk behavior and limited time to provide necessary patient education.

Objective

To determine whether pharmacy-based naloxone co-dispensing affected opioid risk behavior. Secondary objectives were to assess if co-dispensing increased naloxone acquisition, increased patient knowledge about naloxone administration, and affected opioid dose and other substance use.

Design

Cluster randomized pragmatic trial of naloxone co-dispensing.

Setting

Safety-net health system in Denver, Colorado, between 2017 and 2020.

Participants

Seven pharmacies were randomized. Pharmacy patients (N=768) receiving opioids were followed using automated data for 10 months. Pharmacy patients were also invited to complete surveys at baseline, 4 months, and 8 months; 325 survey participants were enrolled from November 15, 2017, to January 8, 2019.

Intervention

Intervention pharmacies implemented workflows to co-dispense naloxone while usual care pharmacies provided usual services.

Main measures

Survey instruments assessed opioid risk behavior; hazardous drinking; tobacco, cannabis, and other drug use; and knowledge. Naloxone dispensings and opioid dose were evaluated using pharmacy data among pharmacy patients and survey participants. Intention-to-treat analyses were conducted using generalized linear mixed models accounting for clustering at the pharmacy level.

Key results

Opioid risk behavior did not differ by trial group (P=0.52; 8-month vs. baseline adjusted risk ratio [ARR] 1.07; 95% CI 0.78, 1.47). Compared with usual care pharmacies, naloxone dispensings were higher in intervention pharmacies (ARR 3.38; 95% CI 2.21, 5.15) and participant knowledge increased (P=0.02; 8-month vs. baseline adjusted mean difference 1.05; 95% CI 0.06, 2.04). There was no difference in other substance use by the trial group.

Conclusion

Co-dispensing naloxone with opioids effectively increased naloxone receipt and knowledge but did not increase self-reported risk behavior.

Trial registration

Registered at ClinicalTrials.gov ; Identifier: NCT03337100.

SUBMITTER: Binswanger IA

PROVIDER: S-EPMC9411391 | biostudies-literature | 2022 Aug

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Naloxone Co-Dispensing with Opioids: a Cluster Randomized Pragmatic Trial.

Binswanger Ingrid A IA Rinehart Deborah D Mueller Shane R SR Narwaney Komal J KJ Stowell Melanie M Wagner Nicole N Xu Stan S Hanratty Rebecca R Blum Josh J McVaney Kevin K Glanz Jason M JM

Journal of general internal medicine 20220207 11

<h4>Background</h4>Although naloxone prevents opioid overdose deaths, few patients prescribed opioids receive naloxone, limiting its effectiveness in real-world settings. Barriers to naloxone prescribing include concerns that naloxone could increase risk behavior and limited time to provide necessary patient education.<h4>Objective</h4>To determine whether pharmacy-based naloxone co-dispensing affected opioid risk behavior. Secondary objectives were to assess if co-dispensing increased naloxone ...[more]

PMID: 35132556

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Dataset Information

Naloxone Co-Dispensing with Opioids: a Cluster Randomized Pragmatic Trial.

Background

Objective

Design

Setting

Participants

Intervention

Main measures

Key results

Conclusion

Trial registration

Publications

Naloxone Co-Dispensing with Opioids: a Cluster Randomized Pragmatic Trial.

Similar Datasets

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