William S. Middleton Memorial Veterans Hospital, 2500 Overlook Terrace, Madison, WI, 53705, United States.
University of Wisconsin-Madison, 1033 / 5109 Rennebohm Hall, 777 Highland Ave, Madison, WI, 53705, United States.
Res Social Adm Pharm. 2021 May;17(5):1017-1020. doi: 10.1016/j.sapharm.2020.08.010. Epub 2020 Aug 22.
Opioid overdose is a major public health concern in the United States. Naloxone education and distribution can decrease the risk of overdose deaths. A previous study showed that a longitudinal, multi-attempt telephone intervention by a single pharmacy resident was effective for distributing naloxone to a high-risk veteran population.
The purpose of this project was to investigate whether a team-based, single-attempt telephone outreach event is effective for distributing naloxone to at-risk outpatient veterans.
The Risk Index for Overdose or Serious Opioid-Induced Respiratory Depression (RIOSORD) tool was used to identify patients with risk class ≥4. Pharmacy trainees contacted 164 patients and offered naloxone. The primary outcome was the proportion of patients with RIOSORD risk class ≥4 who had naloxone before versus after the intervention.
The proportion of patients with RIOSORD class ≥4 who had a naloxone kit before and after the event was 0.28 and 0.63, respectively (difference = 0.35, p < 1 × 10). Per-protocol analysis showed that of 164 patients contacted, 67% were reached (n = 109) and 80 patients accepted naloxone, corresponding to a 73% acceptance rate for those reached.
A team-based telephone outreach event is an effective method for distributing naloxone to at-risk outpatient veterans.
在美国，阿片类药物过量是一个主要的公共卫生问题。纳洛酮教育和分发可以降低过量死亡的风险。先前的一项研究表明，由一名药房住院医师进行的纵向、多次尝试的电话干预，对于向高风险退伍军人人群分发纳洛酮是有效的。
本项目旨在调查团队式、单次尝试的电话外展活动是否能有效地向有风险的门诊退伍军人分发纳洛酮。
使用阿片类药物引起的严重呼吸抑制风险指数（RIOSORD）工具来确定风险等级≥4 的患者。药房学员联系了 164 名患者并提供了纳洛酮。主要结果是 RIOSORD 风险等级≥4 的患者在干预前后接受纳洛酮的比例。
在事件前后，RIOSORD 等级≥4 的患者拥有纳洛酮的比例分别为 0.28 和 0.63（差异=0.35，p<1×10）。按方案分析显示，在联系的 164 名患者中，有 67%（n=109）被联系到，有 80 名患者接受了纳洛酮，这对应于被联系到的患者中有 73%的接受率。
团队式电话外展活动是向有风险的门诊退伍军人分发纳洛酮的有效方法。
