Standard Naloxone Prescribing for Palliative Care Cancer Patients on Opioid Therapy: A Single-Site Quality Improvement Pilot to Assess Attitudes and Access

Background: Limited data exist on when to offer naloxone to cancer patients on opioid therapy. Measures: We assessed patient and clinician attitudes on naloxone education (done via surveys at initial and follow up visits) and prescribing rates (via chart reviews) at a single ambulatory palliative care practice. Pharmacy records assessed naloxone dispense rates. Intervention: During a three-month period, all new patients receiving opioid therapy were offered naloxone. Standardized educational materials on opioid safety and naloxone use were created and shared by clinical team. Outcomes: Naloxone prescribing rates increased from 5% to 66%. 92% (n = 23) of clinicians reported education/prescribing took ≤ five minutes, and 100% reported either a positive or neutral impact on the encounter. A total of 81% (n = 25) of patients reported no increased worry about opioid use, 68% (n = 21) felt safer with naloxone, and 97% rated the encounter as neutral or positive. 88% (n = 37) of prescriptions were dispensed and 67% of patients (n = 16) paid <$10. Conclusions/Lessons Learned: Opioid safety education and naloxone prescribing can be done quickly and is well-received by clinicians and patients.