{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T22:08:08Z","timestamp":1750284488227,"version":"3.32.0"},"reference-count":32,"publisher":"Weston Medical Publishing","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J of Opioid Management"],"abstract":"<jats:p>Objective: To implement an electronic health record best practice advisory (BPA) to promote coprescribing of naloxone to patients at high risk of serious opioid-related adverse events (ORADEs).\r\nDesign: This pre\u2013post quasi-experimental study evaluated 9 months of opioid and naloxone prescription data before and after BPA implementation. \r\nSetting: The Froedtert &amp; the Medical College of Wisconsin enterprise is comprised of 45 ambulatory clinics and 10 hospitals, including the only adult Level 1 trauma center in eastern Wisconsin.\r\nPatients: Patients who received opioid prescriptions in the preimplementation time period (n = 106,615 prescriptions) and post-implementation time period (n = 107,352 prescriptions) were included.\r\nInterventions: BPA activation criteria included entry of a prescription with a morphine equivalent daily dose of 50 or greater with at least a 5-day supply, concomitant opioid and benzodiazepine prescription, or opioid prescription entry for a patient with a documented history of opioid overdose. The BPA defaulted to coprescribe naloxone, while also providing suppression options.\r\nMain outcome measure: The primary endpoint was the change in naloxone prescription rate for patients on chronic opioid therapy (COT) with a morphine milligram equivalent daily dose (MEDD) per day of 50 or greater. \r\nResults: The naloxone coprescription rate for COT patients with a MEDD of 50 or greater increased from 12.2 percent (95 percent confidence interval [CI] 10.4-14.4) to 34.79 percent (95 percent CI 31.8-38.2) after the BPA was implemented (odds ratio 2.85, 95 percent CI 2.37-3.42, p-value &lt; 0.001).\r\nConclusions: Use of BPA increased the rate of naloxone coprescribing for patients at risk of serious ORADE.<\/jats:p>","DOI":"10.5055\/jom.0866","type":"journal-article","created":{"date-parts":[[2024,12,27]],"date-time":"2024-12-27T19:27:11Z","timestamp":1735327631000},"page":"471-486","source":"Crossref","is-referenced-by-count":1,"title":["Naloxone coprescribing best practice advisory for patients at high risk for opioid-related adverse events"],"prefix":"10.5055","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3236-9390","authenticated-orcid":false,"given":"Holly","family":"Sheldon","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathan","family":"Duncan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amit","family":"Singh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Endrizzi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan","family":"Conrardy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruta","family":"Brazauskas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Peppard","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3008","published-online":{"date-parts":[[2024,12,1]]},"reference":[{"key":"92536","unstructured":"Centers for Disease Control and Prevention: Understanding the opioid epidemic. Available at www.cdc.gov\/opioids\/basics\/epidemic.html. Accessed September 23, 2022."},{"key":"92537","unstructured":"National Institute on Drug Abuse: Drug overdose death rates. Available at www.nida.nih.gov\/research-topics\/trendsstatistics\/overdose-death-rates#:~:text=In%202021%2C%20the%20number%20of,(Source%3A%20CDC%20WONDER). Accessed May 26, 2023."},{"key":"92538","doi-asserted-by":"crossref","unstructured":"Dowell D, Haegerich TM, Chou R: CDC guideline for prescribing opioids for chronic pain. Morb Mortal Wkly Rep. 2016; 65(1): 1-49.","DOI":"10.15585\/mmwr.rr6501e1er"},{"key":"92539","unstructured":"National Institute on Drug Abuse: Naloxone DrugFacts. Available at https:\/\/nida.nih.gov\/publications\/drugfacts\/naloxone. Accessed September 23, 2022."},{"key":"92540","unstructured":"Centers for Disease Control and Prevention: 2019-2020 Prescription opioid overdose data. Available at www.cdc.gov\/drugoverdose\/deaths\/prescription\/2019-2020.html. Accessed November 11, 2022."},{"key":"92541","unstructured":"The Network for Public Health Law: Naloxone prescription mandates. Available at www.networkforphl.org\/wp-content\/uploads\/2023\/07\/Fact-Sheet-Naloxone-Prescription-Mandates-2022-update.pdf. Accessed January 29, 2024."},{"key":"92542","unstructured":"Emergent BioSolutions: Narcan nasal spray. Available at www.narcan.com\/patients\/how-to-get-narcan\/. Accessed January 29, 2024."},{"key":"92543","unstructured":"Wisconsin Department of Health Services: Dose of reality: Opioid deaths by county dashboard. Available at www.dhs.wisconsin.gov\/opioids\/dashboards.htm. Accessed September 23, 2022; Jones CM: Candidates for naloxone: What the data tell us. CDC."},{"key":"92544","unstructured":"FMCW: About Froedtert & the Medical College of Wisconsin Regional Health Network. Available at www.froedtert.com\/about. Accessed November 11, 2022."},{"key":"92545","unstructured":"Centers for Disease Control and Prevention: When to offer naloxone to patients. Available at www.cdc.gov\/opioids\/naloxone\/factsheets\/pdf\/Naloxone_FactSheet_Clinicians.pdf. Accessed September 23, 2022."},{"key":"92546","unstructured":"Office of the Surgeon General: US Surgeon General's advisory on naloxone and opioid overdose. Available at www.hhs.gov\/surgeongeneral\/reports-and-publications\/addiction-andsubstance-misuse\/advisory-on-naloxone\/index.html. Accessed September 23, 2022."},{"key":"92547","unstructured":"US Department of Veteran Affairs: Opioid overdose prevention and reversing an overdose with naloxone. Available at www.pbm.va.gov\/PBM\/AcademicDetailingService\/Documents\/508\/IB10-1539OEND_OverdosePreventionwithNaloxone_508Ready.pdf. Accessed September 23, 2022."},{"key":"92548","unstructured":"Wisconsin Department of Health Services: Opioid safety and overdose prevention guide. Available at www.dhs.wisconsin.gov\/opioids. Accessed September 23, 2022."},{"key":"92549","unstructured":"Raghavachari R: NDA 208411\/S-004 approval letter. US FDA. Available at www.accessdata.fda.gov\/drugsatfda_docs\/appletter\/2020\/208411Orig1s004ltr.pdf. Accessed November 14, 2022."},{"key":"92550","unstructured":"Elsevier ClinicalKey: Patient education: Naloxone nasal spray. 2021. Available at https:\/\/www.clinicalkey.com\/#!\/content\/patient_handout\/5-s2.0-pe_30bc2d8a-3732-457f-875b-13fd73d242ae. Accessed November 2, 2021."},{"key":"92551","unstructured":"UpToDate: How to give naloxone. 2021. Available at https:\/\/www.uptodate.com\/contents\/how-to-give-naloxone-thebasics?search=how%20to%20give%20naloxone&source=search_result&selectedTitle=4%7E150&usage_type=default&display_rank=3. Accessed November 2, 2021."},{"key":"92552","unstructured":"DHS WI Naloxone Training: Youtube video published December 17, 2020. Available at https:\/\/youtube.com\/watch?v=XH2mkQC3-fc. Accessed May 14, 2024."},{"key":"92553","unstructured":"NARCAN (naloxone hydrochloride) nasal spray: Instructions for use. 2020. Available at https:\/\/www.youtube.com\/watch?v=WnjgrRNMfKM. Accessed May 14, 2024."},{"key":"92554","unstructured":"NARCAN: Nasal spray\u2014How to use. Available at https:\/\/narcan.com. Accessed January 29, 2024."},{"key":"92555","unstructured":"Adapt Pharma: NARCAN (naloxone HCl) nasal spray 4 mg [Package insert]. Revised August 2020. Plymouth Meeting, PA. Available at https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2015\/208411lbl.pdf. Accessed May 14, 2024."},{"key":"92556","doi-asserted-by":"crossref","unstructured":"Peppard W, Sheldon H, Endrizzi S, et al.: Racial equity in opioid prescribing: A pharmacist-led multidisciplinary health system assessment. J Am Coll Clin Pharm. 2022; 5(9): 959-973.","DOI":"10.1002\/jac5.1627"},{"key":"92557","unstructured":"Bartoszek M, Dragovich A, Algeo D, et al.: Operation Opioid SAFE: Executive Summary. FortBragg, NC: Womack Army Medical Center, 2012."},{"key":"92558","doi-asserted-by":"crossref","unstructured":"Albert SU, Brason FW, Sanford CK, et al.: Project Lazarus: Community-based overdose prevention in rural North Carolina. Pain Med. 2011; 12(Suppl. 2): S77-S85.","DOI":"10.1111\/j.1526-4637.2011.01128.x"},{"key":"92559","doi-asserted-by":"crossref","unstructured":"Sandbrink F, Oliva EM, McMullen TL, et al.: Opioid prescribing and opioid risk mitigation strategies in the veterans health administration. J Gen Intern Med. 2020; 35(Suppl. 3): 927-934.","DOI":"10.1007\/s11606-020-06258-3"},{"key":"92560","doi-asserted-by":"crossref","unstructured":"Gruver BR, Jiroutek MR, Kelly KE: Naloxone coprescription in US ambulatory care centers and emergency departments. J Am Pharm Assoc (2003). 2020; 60(5): e44-e49.","DOI":"10.1016\/j.japh.2020.03.009"},{"key":"92561","doi-asserted-by":"crossref","unstructured":"Jones CM, Compton W, Vythilingam M, et al.: Naloxone co-prescribing to patients receiving prescription opioids in the Medicare part D program, United States, 2016-2017. JAMA. 2019; 322(5): 462-464. DOI: 10.1001\/jama.2019.7988.","DOI":"10.1001\/jama.2019.7988"},{"key":"92562","doi-asserted-by":"crossref","unstructured":"Bohnert AS, Valenstein M, Bair MJ, et al.: Association between opioid prescribing patterns and opioid overdose-related deaths. JAMA. 2011; 305(13): 1315-1321.","DOI":"10.1001\/jama.2011.370"},{"key":"92563","unstructured":"National Heart, Lung, and Blood Institute: Evidence based management of sickle cell disease. Available at www.nhlbi.nih.gov\/health-topics\/evidence-based-management-sickle-celldisease. Accessed January 29, 2024."},{"key":"92564","doi-asserted-by":"crossref","unstructured":"Ballas SK: Opioids are not a major cause of death of patients with sickle cell disease. Ann Hematol. 2021; 100(5): 1133-1138.","DOI":"10.1007\/s00277-021-04502-2"},{"key":"92565","doi-asserted-by":"crossref","unstructured":"Siff JE, Margolius D, Papp J, et al.: A healthcare system-level intervention to increase naloxone availability for patients with opioid prescriptions. Am J Addict. 2021; 30(2): 179-182.","DOI":"10.1111\/ajad.13136"},{"key":"92566","doi-asserted-by":"crossref","unstructured":"Nelson SD, McCoy AB, Rector H, et al.: Assessment of a naloxone coprescribing alert for patients at risk of opioid overdose: A quality improvement project. Anesth Analg. 2022; 135(1): 26-34.","DOI":"10.1213\/ANE.0000000000005976"},{"key":"92567","doi-asserted-by":"crossref","unstructured":"Devries J, Rafie S, Polston G: Implementing an overdose education and naloxone distribution program in a health system. J Am Pharm Assoc (2003). 2017; 57(2S): S154-S160.","DOI":"10.1016\/j.japh.2017.01.002"}],"container-title":["Journal of Opioid Management"],"original-title":[],"link":[{"URL":"https:\/\/wmpllc.org\/ojs\/index.php\/jom\/article\/download\/3744\/4028","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/wmpllc.org\/ojs\/index.php\/jom\/article\/download\/3744\/4028","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,27]],"date-time":"2024-12-27T19:27:21Z","timestamp":1735327641000},"score":1,"resource":{"primary":{"URL":"https:\/\/wmpllc.org\/ojs\/index.php\/jom\/article\/view\/3744"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,1]]},"references-count":32,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2024,12,17]]}},"URL":"https:\/\/doi.org\/10.5055\/jom.0866","relation":{},"ISSN":["1551-7489","1551-7489"],"issn-type":[{"value":"1551-7489","type":"electronic"},{"value":"1551-7489","type":"print"}],"subject":[],"published":{"date-parts":[[2024,12,1]]}}}