Pharmacists, front office staff and physicians worked together to boost the number of naloxone prescriptions at a clinic in rural Oregon, according to a report in Annals of Family Medicine.
CDC data show that residents of the most rural counties in the U.S. were 87% more likely to receive an opioid prescription than those living in large metropolitan counties. Previous reports have indicated nonurban areas of the U.S. are among the hardest hit by the opioid epidemic.
Nicholas B. West, DMD, of Winding Waters Clinic at Oregon Health & Science University, explained the six multi-disciplinary steps that create the note in an interview with Healio Primary Care.
“A pharmacist scrubs the chart every 3 months for patients prescribed more than 50 morphine equivalent doses and writes them a Narcan prescription. Then, the front office staff schedules appointments for them. When the patient comes in, the attending physician judges if the patient can taper the opioid dose with the prescribed Narcan. If so, the patient discusses Narcan use with the pharmacist and picks up their prescription,” he said.
West and colleagues wrote in the Annals study that 6 months after implemented the initiative, the number of naloxone prescriptions increased.
West said the review, though only tested in a rural area, has universal applicability.
A chart review started by a pharmacist but ultimately allowed a primary care physicians to decide if a proposed naloxone prescription would help a patient taper off opioids increased naloxone prescriptions at a clinic in rural Oregon, according to a report in Annals of Family Medicine.
“I cannot think of specific modifications that would be necessary for an urban setting vs. rural setting. It can be used elsewhere, regardless of rurality,” he said in the interview.
“The largest burden is the EPIC Report for opioids. Depending on what EHR or EPIC upgrade PCPs have, they might have access to reports that automatically calculate the morphine equivalent dose,” he said. “Ours did not calculate for us and so I spent a considerable amount of time monotonously calculating the morphine equivalent doses for various patients,” West added. – by Janel Miller
Disclosures: The authors report no relevant financial disclosures.