Current practices in naloxone prescribing upon hospital discharge

Michelle Punzal, MD; Patricia Santos, MD, MBA; Xiaoshu Li, PhD; Douglas R. Oyler, PharmD; Alan M. Hall, MD

doi:10.5055/jom.2019.0524

Authors

Michelle Punzal, MD
Patricia Santos, MD, MBA
Xiaoshu Li, PhD
Douglas R. Oyler, PharmD
Alan M. Hall, MD

DOI:

https://doi.org/10.5055/jom.2019.0524

Keywords:

naloxone, opioid use disorder, opioid overdose

Abstract

Objective: To evaluate current practices in naloxone prescribing upon hospital discharge.

Design: Electronic cross-sectional survey.

Setting: Academic medical center.

Participants: Inpatient physicians and advanced practice providers.

Main outcome measures: Respondents completed survey items including current naloxone prescribing practices, barriers to naloxone prescribing, and methods to improve naloxone prescribing.

Results: The survey response rate was 51.6 percent. Greater than 90 percent of respondents agreed that naloxone should be prescribed for patients with an active opioid use disorder, history of overdose, and use of greater than 50 morphine milligram equivalents per day. Lack of patient education on proper use of naloxone was the most identified barrier to prescribing.

Conclusions: Providers agree with the Centers for Disease Control and Prevention recommendations to prescribe naloxone to high-risk patients. Certain barriers affect the rate of naloxone prescribing at discharge, including lack of time, patient education, provider training, and concern for increasing riskier behaviors.

Author Biographies

Michelle Punzal, MD

Department of Internal Medicine, Medstar Georgetown University Hospital, Washington, DC

Patricia Santos, MD, MBA

Department of Internal Medicine, University of Kentucky College of Medicine, Lexington, Kentucky

Xiaoshu Li, PhD

Center for Health Services Research, University of Kentucky College of Medicine, Lexington, Kentucky

Douglas R. Oyler, PharmD

Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, Lexington, Kentucky

Alan M. Hall, MD

Department of Internal Medicine, University of Kentucky College of Medicine, Lexington, Kentucky; Department of Pediatrics, University of Kentucky College of Medicine, Lexington, Kentucky

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