Alexander G Rittel1, Krista B Highland2,3, Mark S Maneval4, Archie D Bockhorst5, Agustin Moreno1, Alan Sim6, Peter S Easter1, Chris E Nichols6, Ryan C Costantino1. 1. Enterprise Intelligence and Data Solutions (EIDS) program office, Program Executive Office, Defense Healthcare Management Systems (PEO DHMS), San Antonio, TX,USA. 2. Defense & Veterans Center for Integrative Pain Management, and Department of Anesthesiology, Uniformed Services University, Bethesda, MD,USA. 3. The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Rockville, MD, USA. 4. Boehringer Ingelheim Pharmaceuticals, Seattle, WA,USA. 5. Analytics & Evaluation Division, Strategy, Planning, and Functional Integration (J-5) Defense Health Agency, San Antonio, TX,USA. 6. Enterprise Intelligence and Data Solutions (EIDS) program office, Program Executive Office, Defense Healthcare Management Systems (PEO DHMS), Rosslyn, VA,USA.
Abstract
PURPOSE: To describe the development, implementation, and evaluation of a pharmacy clinical decision support tool designed to increase naloxone coprescription among people at risk for opioid overdose in a large healthcare system. SUMMARY: The Military Health System Opioid Registry and underlying presentation layer were used to develop a clinical decision support capability to improve naloxone coprescription at the pharmacy point of care. Pharmacy personnel use a patient identification card barcode scanner or manually enter a patient's identification number to quickly visualize information on a patient's risk for opioid overdose and medical history related to pain and, when appropriate, receive a recommendation to coprescribe naloxone. The tool was made available to military treatment facility pharmacy locations. An interactive dashboard was developed to support monitoring, utilization, and impact on naloxone coprescription to patients at risk for opioid overdose. CONCLUSION: Initial implementation of the naloxone tool was slow from a lack of end-user awareness. Efforts to increase utilization were, in part, successful owing to a number of enterprise-wide educational initiatives. In early 2020, the naloxone tool was used in 15% of all opioid prescriptions dispensed at a military pharmacy. Data indicate that the frequency of naloxone coprescription to patients at risk for opioid overdose was significantly higher when the naloxone tool was used than when the tool was not used. Published by Oxford University Press on behalf of the American Society of Health-System Pharmacists 2021.
PURPOSE: To describe the development, implementation, and evaluation of a pharmacy clinical decision support tool designed to increase naloxone coprescription among people at risk for opioid overdose in a large healthcare system. SUMMARY: The Military Health System Opioid Registry and underlying presentation layer were used to develop a clinical decision support capability to improve naloxone coprescription at the pharmacy point of care. Pharmacy personnel use a patient identification card barcode scanner or manually enter a patient's identification number to quickly visualize information on a patient's risk for opioid overdose and medical history related to pain and, when appropriate, receive a recommendation to coprescribe naloxone. The tool was made available to military treatment facility pharmacy locations. An interactive dashboard was developed to support monitoring, utilization, and impact on naloxone coprescription to patients at risk for opioid overdose. CONCLUSION: Initial implementation of the naloxone tool was slow from a lack of end-user awareness. Efforts to increase utilization were, in part, successful owing to a number of enterprise-wide educational initiatives. In early 2020, the naloxone tool was used in 15% of all opioid prescriptions dispensed at a military pharmacy. Data indicate that the frequency of naloxone coprescription to patients at risk for opioid overdose was significantly higher when the naloxone tool was used than when the tool was not used. Published by Oxford University Press on behalf of the American Society of Health-System Pharmacists 2021.
Authors: Jennifer Pakieser; Sidney Peters; Laura C Tilley; Ryan C Costantino; Maya Scott-Richardson; Krista B Highland Journal: Pain Rep Date: 2021-03-14