Session Information
Session Time: None. Available on demand.
Disclosures: Shane N. Stone, MD: No financial relationships or conflicts of interest
Objective: To determine if naloxone is appropriately prescribed to patients at highest risk of complications from their opioid treatment.
Design: A retrospective review of patient medical records was completed to determine medications prescribed and medical comorbidities. All opioid prescriptions were converted to Morphine Milligram Equivalents (MME). Patients appropriate for naloxone (“at-risk”) were defined as those prescribed opioids at ≥50MME/day, < 50MME/day and a pulmonary or psychiatric comorbidity, or < 50MME/day using marijuana or benzodiazepines (MJ/BZ).
Setting: Outpatient pain clinic at a tertiary academic rehabilitation hospital.
Participants: 168 patients ≥18 years old who had telehealth visits with three accredited pain-medicine, PM&R physicians from May 4 to May 31, 2022.
Interventions: Not applicable.
Main Outcome Measures: The percent of patients at high-risk for complications who received naloxone.
Results: During the study period, 129 opioid prescriptions (MME Range 0-1080, mean 62.375, and median 20.25) were written for 102 patients (37 patients received prescriptions for >1 opioid). 65 (63.73%) patients qualified for naloxone due to receiving an “at-risk” prescription (MME range 1.5-1080, mean 145.40). 54 (83.08%) patients were “at-risk” due to ≥50MME/day, 6 (9.23%) for < 50MME/day and on MJ/BZ, and 5 (7.69%) for < 50MME/day and a comorbidity. Oxycodone (34), hydrocodone (24), and fentanyl (11) had the highest total number of naloxone-eligible prescriptions. Of the qualified patients, 5 (7.62%) received a prescription for naloxone (MME range 150-376).
Conclusions: At this dedicated pain clinic, a fraction of eligible patients received naloxone prescriptions. Of the five prescriptions, only two were written (unprompted) by the clinic providers. With deaths from opioid overdose continuing to rise, education and policies focused on making changes to the prescribing practices of providers regularly using opioids is an opportunity to make an impact on this public health epidemic.
Level of Evidence: Level II
To cite this abstract in AMA style:
Stone SN, Curley N, Butler C, Margolis S. Naloxone Prescribing Practices in an Outpatient Pain Clinic: A Retrospective Review [abstract]. PM R. 2022; 14(S1)(suppl 1). https://pmrjabstracts.org/abstract/naloxone-prescribing-practices-in-an-outpatient-pain-clinic-a-retrospective-review/. Accessed September 7, 2024.« Back to AAPM&R Annual Assembly 2022
PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/naloxone-prescribing-practices-in-an-outpatient-pain-clinic-a-retrospective-review/