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Naloxone Counseling for Harm Reduction & Patient Engagement Lucas G. Hill, PharmD, BCPS Clinical Assistant Professor University of Texas at Austin College of Pharmacy 2016 Innovation in Healthcare Delivery Systems Symposium April 8, 2016

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Naloxone Counseling for Harm Reduction & Patient Engagement

Lucas G. Hill, PharmD, BCPS

Clinical Assistant Professor University of Texas at Austin College of Pharmacy 2016 Innovation in Healthcare Delivery Systems Symposium April 8, 2016

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U.S. Department of Health & Human Services. Addressing Prescription Drug Abuse in the United States. CDC Website.

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Paulozzi et al. Vital Signs: Overdoses of Prescription Opioid Pain Relievers – United States, 1999-2008. MMWR 2011;60:1487-92.

From 1999 – 2008… Prescribe: é x4 Death: é x4 Rehab: é x6

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Hedegaard et al. Drug-poisoning deaths involving opioid analgesics: United States, 1999-2011. NCHS Data Brief #190.

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Hedegaard et al. Drug-poisoning deaths involving opioid analgesics: United States, 1999-2011. NCHS Data Brief #190.

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Overdose Data: Allegheny County. Overdose Free PA Website.

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Overdose Data: Allegheny County. Overdose Free PA Website.

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Overdose Data: Allegheny County. Overdose Free PA Website.

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Overdose Data: Allegheny County. Overdose Free PA Website.

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Hunt et al. A Review of the Evidence-Base for Harm Reduction Approaches to Drug Use. IHRA Website.

Five Principles of Harm Reduction

Pragmatism Humanism Harm Focus Cost/Benefit Prioritize

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San Francisco Dept of Public Health. Naloxone for Opioid Safety. CHCF Website.

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Results

Dates Letters Kits 2/1/14 – 5/31/15 71 97

60% 36% 4% Indication for Naloxone Illicit Opioid RX Opioid Caregiver

0% 20% 40% 60% 80% 100% Low Neutral High Level of comfort talking to PCP about opioid use (n=16 patients)

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Results

0% 20% 40% 60% 80% 100% Disagree Neutral Agree Face-to-face naloxone counseling improves my satisfaction caring for new patients seeking refills of chronic opioids (n=22 FMR)

5 Reversals Reported

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Conclusions

A naloxone counseling intervention implemented in three patient-centered medical homes enhanced provider satisfaction and prevented overdose deaths.

Expansion

Multicenter emergency department naloxone dispensing
Inpatient FM service naloxone counseling and dispensing

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Texas SB1462

Naloxone standing orders (e.g. PharmD)
Third-party prescribing to family/caregivers
Liability protection for prescribers

Interested?

Email: lucas.hill@austin.utexas.edu
Working with pharmacy student organization volunteers
Looking for small grants to support free naloxone kits

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Naloxone Counseling for Harm Reduction & Patient Engagement

Lucas G. Hill, PharmD, BCPS lucas.hill@austin.utexas.edu Acknowledgments Jonathan Han, MD; Marianne Koenig, PharmD; Alice Bell, LCSW; UPMC St. Margaret Departments of Family Medicine & Pharmacy