a Clinical Pharmacy Specialist, Primary Care Mental Health Integration, South Texas Veterans Health Care System , 4610 East Southcross Blvd Suite 105, San Antonio , TX 78222.
b Clinical Pharmacy Specialist, Pain Management, Associate Director, PGY2 Pain & Palliative Care Pharmacy Residency, West Palm Beach Veterans Affairs Medical Center, 7305 North Military Trail (119) , West Palm Beach , FL 33410.
Subst Abus. 2018;39(2):206-210. doi: 10.1080/08897077.2018.1449174.
In recognition of the importance of safe and effective pain management, the Department of Veterans Affairs and the Office of the Under Secretary for Health have encouraged implementation of opioid overdose education and naloxone distribution (OEND) programs at Veterans Affairs Medical Centers (VAMCs).
An OEND program was developed in August 2015 and implemented in September 2015 at a VAMC which allowed for pharmacist-lead individual and group patient education. An OEND consult service was developed to streamline referrals of patients for naloxone education and distribution. At the conclusion of the class, participants were ordered a naloxone auto-injector or nasal spray kit. To evaluate the utility of this quality-improvement initiative, data was collected from September 2015 until May 2016. Examples of data collected included participant satisfaction with education, risk for accidental overdose, and number of naloxone kits dispensed to participants.
Of a total of 243 consults placed, 71 individuals participated in OEND education. A large quantity of consults were discontinued due to patients no-showing education. Sixty-four consult referrals were identified to have a mental health diagnosis. Most participants who received education had a risk for accidental opioid overdose of 14%. Sixty-nine education participants were provided a naloxone kit. Based on the OEND class survey, participants felt that their knowledge of accidental opioid overdose increased and were generally satisfied with the education.
OEND educated 30% of the Veterans referred into the program via the consult service, the majority of whom were at a relatively low risk for opioid overdose.
鉴于安全有效管理疼痛的重要性，退伍军人事务部和卫生副部长办公室鼓励退伍军人事务医疗中心实施阿片类药物过量教育和纳洛酮分发（OEND）计划。
2015 年 8 月制定了 OEND 计划，并于 2015 年 9 月在一家退伍军人事务医疗中心实施，该计划允许药剂师主导对患者进行个人和小组教育。制定了 OEND 咨询服务，以简化向患者提供纳洛酮教育和分发的转介。课程结束后，为参与者开出处方纳洛酮自动注射器或鼻喷雾剂套件。为了评估这一质量改进计划的效用，从 2015 年 9 月到 2016 年 5 月收集了数据。收集的数据示例包括参与者对教育的满意度、意外过量用药的风险以及分发给参与者的纳洛酮套件数量。
共进行了 243 次咨询，71 人参加了 OEND 教育。由于患者未参加教育，大量咨询被取消。有 64 次咨询转介被确定为有心理健康诊断。接受教育的大多数参与者意外阿片类药物过量的风险为 14%。69 名教育参与者获得了纳洛酮套件。根据 OEND 课程调查，参与者认为他们对意外阿片类药物过量的知识有所增加，并且对教育普遍感到满意。
通过咨询服务，有 30%的被转诊参加 OEND 计划的退伍军人接受了教育，其中大多数人意外阿片类药物过量的风险相对较低。
