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Am J Health Syst Pharm. 2018 Mar 15;75(6):376-383. doi: 10.2146/ajhp170294.

Establishment of a pharmacist-led service for patients at high risk for opioid overdose.

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New Hanover Regional Medical Center, Wilmington, NC
New Hanover Regional Medical Center, Wilmington, NC.



A program at a family medicine clinic to provide naloxone prescriptions in conjunction with education on naloxone use and opioid hazards to patients at risk for opioid overdose is described.


Consistent with a 2016 Centers for Disease Control and Prevention (CDC) guideline on opioid prescribing for chronic pain, a family medicine clinic implemented updated controlled substance agreements and medical record templates for documentation of pain management visits and established a pharmacist-led naloxone clinic. Chart reviews were performed to identify patients eligible for naloxone, as defined by the CDC guideline. A standard visit template was constructed to guide patient education regarding overdose risks and naloxone use. The teach-back method was used to ensure patient understanding, and patients were encouraged to bring a friend or family member to clinic visits. To address medication access barriers, community resources for patient referral for assistance were identified. Barriers to attendance at pharmacist-conducted visits necessitated changes in clinic workflow to incorporate education into prescheduled physician visits and education of some patients via telephone. During the first 6 months of clinic operations, 49 patients were identified as being at risk for opioid overdose; pharmacists educated 84% of those patients and subsequently confirmed that 69% had filled a naloxone prescription.


Naloxone prescribing and provision of education on naloxone use to at-risk patients in a family medicine clinic can help ensure access to life-saving medication and reinforce CDC recommendations on safe prescribing of opioids.


ambulatory care; education; family practice; naloxone; opioid analgesics; pharmacists

[Indexed for MEDLINE]

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