Impact of Clinical Pharmacy Team Intervention on Naloxone Fills in Patients on Chronic Opioid Therapy.

Background: Opioids are highly effective for pain management but carry risks. Naloxone quickly reverses opioid overdoses by blocking opioid receptors in the brain. Despite its effectiveness, naloxone remains underutilized. Kaiser Permanente created the Interregional Pharmacy Opioid Use Improvement Group to support safe opioid prescribing and increase appropriate naloxone prescribing.

Methods: This retrospective study included Kaiser Permanente Georgia members who were 18 years or older and filling chronic opioid therapy of ≥ 50 morphine milligram equivalents (MME) averaged over the previous 90 days. The primary objective was to compare the number of patients who filled a naloxone prescription within the last 24 months as of March 31, 2023 (preintervention) vs as of December 31, 2023 (postintervention). The secondary outcome was to compare the naloxone fill rates based on intervention type.

Results: As of March 31, 2023, 122 out of 399 patients (30.6%) had filled naloxone prescriptions compared to 241 out of 356 patients (67.7%) as of December 31, 2023 (30.6% vs 67.7%; P < .0001). Out of 56 patients who received only a secure email, 42 (75%) filled their prescriptions. For patients who spoke directly with a pharmacist or technician, 91 (91%) filled their prescriptions. Among patients who were not directly reached and received a voicemail, 15 (41%) filled their prescriptions.

Conclusions: Pharmacy-led interventions, particularly telephone outreach, were effective at improving naloxone fill rates in patients on chronic opioid therapy of ≥ 50 morphine milligram equivalents per day. Voicemails had a lower fill rate, highlighting the importance of direct interaction in improving patient outcomes.