title: Implementing an overdose education and naloxone distribution program in a health system.
abstract: OBJECTIVE
  To design and implement a health system-wide program increasing provision of take-home naloxone in patients at risk for opioid overdose, with the downstream aim of reducing fatalities. The program includes health care professional education and guidelines, development, and dissemination of patient education materials, electronic health record changes to promote naloxone prescriptions, and availability of naloxone in pharmacies.
  
  
  METHODS
  Academic health system, San Diego, California.
  
  
  METHODS
  University of California, San Diego Health (UCSDH), offers both inpatient and outpatient primary care and specialty services with 563 beds spanning 2 hospitals and 6 pharmacies. UCSDH is part of the University of California health system, and it serves as the county's safety net hospital.
  
  
  METHODS
  In January 2016, a multisite academic health system initiated a system-wide overdose education and naloxone distribution program to prevent opioid overdose and opioid overdose-related deaths. An interdisciplinary, interdepartmental team came together to develop and implement the program. To strengthen institutional support, naloxone prescribing guidelines were developed and approved for the health system. Education on naloxone for physicians, pharmacists, and nurses was provided through departmental trainings, bulletins, and e-mail notifications. Alerts in the electronic health record and preset naloxone orders facilitated co-prescribing of naloxone with opioid prescriptions.
  
  
  RESULTS
  Electronic health record reports captured naloxone prescriptions ordered. Summary reports on the electronic health record measured naloxone reminder alerts and response rates.
  
  
  RESULTS
  Since the start of the program, the health system has trained 252 physicians, pharmacists, and nurses in overdose education and take-home naloxone. There has been an increase in the number of prescriptions for naloxone from a baseline of 4.5 per month to an average of 46 per month during the 3 months following full implementation of the program including implementation of electronic health record alerts.
  
  
  CONCLUSIONS
  Initiating and implementing an overdose education and naloxone distribution program is feasible in an academic health system.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Devries
authors.forename: Sally
authors.initials: S
authors.lastname: Rafie
authors.forename: Gregory
authors.initials: G
authors.lastname: Polston
mesh_terms: D000046:Academic Medical Centers; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects; D002140:California; D062787:Drug Overdose / Q000188:drug therapy*; D057286:Electronic Health Records; D006282:Health Personnel / Q000193:education; D006801:Humans; D009270:Naloxone / Q000008:administration & dosage* / Q000600:supply & distribution; D009292:Narcotic Antagonists / Q000008:administration & dosage / Q000627:therapeutic use; D009293:Opioid-Related Disorders / Q000150:complications* / Q000188:drug therapy; D010353:Patient Education as Topic / Q000379:methods; D010593:Pharmaceutical Services / Q000458:organization & administration; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D016730:Program Development
chemical_list: D000701:Analgesics, Opioid; D009292:Narcotic Antagonists; D009270:Naloxone