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

Purpose. 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. Summary. 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. Conclusion. 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.