Evaluation of Naloxone take-Home kit distribution to emergency department patients treated and released for opioid overdoseWelk, Amanda (2017) Evaluation of Naloxone take-Home kit distribution to emergency department patients treated and released for opioid overdose. Master Essay, University of Pittsburgh.
AbstractPurpose: The United States (U.S.) is encountering an opioid public health crisis. Opioid use disorder (OUD) and overdose has become a top public health issue and a burden on health care costs and mortality rates. In 2016, there were over 33,000 deaths from opioid overdose in the U.S., and 3,383 deaths in Pennsylvania (PA). Due to this public health concern, the Allegheny General Hospital (AGH) Emergency Department (ED) strives to provide all opioid overdose patients with either a prescription for naloxone or naloxone take-home kit prior to patient discharge. Naloxone is an opioid antagonist that binds to opioid receptors. Naloxone therapy is used in opioid overdose because it displaces the opioid drug from the receptors and reverses the effects, particularly death from opioid overdose induced respiratory depression and hypotension. Methods: The primary objective of this retrospective quality improvement study was to determine the number of patients treated and released in the AGH ED for opioid overdose. Secondary objectives included determining the percentage of opioid overdose patients with health insurance, the percentage of opioid overdose patients provided a naloxone prescription or naloxone take-home kit prior to ED discharge, and mean ED length of stay of these patients. Identification of study patients was determined using ED discharge diagnoses; heroin overdose, drug overdose, narcotic overdose, opiate overdose, general overdose, and various trauma diagnoses. Data was obtained using AGH’s electronic medical records. Results: From October 1, 2016 through December 31, 2016, a total of 103 unique patients with 106 visits were treated and released for opioid overdose. Patients were mostly male (70.6%), with a mean age 37 years (range 27-64 years). Seventy-nine percent (81/103) of patients were insured. Take-home naloxone was provided in 58 percent (61/106) of ED visits, and mean ED length of stay was 165 minutes (range: 12-733 minutes). Conclusion: This information can be used to anticipate the future volume of patients treated and released in AGH ED for opioid overdose and assist in the design of a sustainable take-home naloxone program. Share
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