ArticleJoint Commission journal on quality and patient safety2021
Increasing Naloxone Prescribing in the Emergency Department Through Education and Electronic Medical Record Work-Aids.
Article in Joint Commission journal on quality and patient safety, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.
- The role of information systems in emergency department decision-making-a literature review.Journal of the American Medical Informatics Association : JAMIA · 2024Pooled it
- Take-home naloxone in multicentre emergency settings: the TIME feasibility cluster RCT.Health technology assessment (Winchester, England) · 2024Trial
- Take-home naloxone administered in emergency settings: feasibility of intervention implementation in a cluster randomized trial.BMC emergency medicine · 2024Trial
- Mixed-methods Evaluation of an Expedited Partner Therapy Take-home Medication Program: Pilot Emergency Department Intervention to Improve Sexual Health Equity.The western journal of emergency medicine · 2023Trial
- Best Practice Alerts Informed by Inpatient Opioid Intake to Reduce Opioid Prescribing after Surgery (PRIOR): A Cluster Randomized Multiple Crossover Trial.Anesthesiology · 2023Trial
- A scoping review of emergency department take-home naloxone on patient and health outcomes.CJEM · 2026Article
- Development of a Low-Barrier, Reimbursable Take-Home Naloxone Program at a Regional Health System.The western journal of emergency medicine · 2025Article
- Iterative Development of a Clinical Decision Support Tool to Enhance Naloxone Coprescribing.Applied clinical informatics · 2025Article
- Clinical Decision Support to Increase Emergency Department Naloxone Coprescribing: Implementation Report.JMIR medical informatics · 2024Article
- Opioid-specific harm reduction in the emergency department: how staff provide harm reduction and contextual factors that impact their capacity to engage in harm reduction practice.Harm reduction journal · 2024Article
- Article
- Effect of Best Practice Alert (BPA) on Post-Discharge Opioid Prescribing After Minimally Invasive Hysterectomy: A Quality Improvement Study.Journal of pain research · 2024Article
- Harm reduction in undergraduate and graduate medical education: a systematic scoping review.BMC medical education · 2023Article
- Electronic Advisories Increase Naloxone Prescribing Across Health Care Settings.Journal of general internal medicine · 2023Article
- The effectiveness of a noninterruptive alert to increase prescription of take-home naloxone in emergency departments.Journal of the American Medical Informatics Association : JAMIA · 2023Observational
- Patient perspectives on naloxone receipt in the emergency department: a qualitative exploration.Harm reduction journal · 2022Article
- Prescribing Naloxone to High-Risk Patients in the Emergency Department: Is it Enough?Joint Commission journal on quality and patient safety · 2021Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
backgroundEmergency department (ED) visits for opioid overdose continue to rise. Evidence-based harm reduction strategies for opioid use disorder (OUD), such as providing home naloxone, can save lives, but ED implementation remains challenging.
methodsThe researchers aimed to increase prescribing of naloxone to ED patients with OUD and opioid overdose by employing a model for improvement methodology, a multidisciplinary team, and high-reliability interventions. Monthly naloxone prescribing rates among discharged ED patients with opioid overdose and OUD-related diagnoses were tracked over time. Interventions included focused ED staff education on OUD and naloxone, and creation of electronic medical record (EMR)-based work-aids, including a naloxone Best Practice Advisory (BPA) and order set. Autoregressive interrupted time series was used to model the impact of these interventions on naloxone prescribing rates. The impact of education on ED staff confidence and perceived barriers to prescribing naloxone was measured using a published survey instrument.
resultsAfter adjusting for education events and temporal trends, ED naloxone BPA and order set implementation was associated with a significant immediate 21.1% increase in naloxone prescribing rates, which was sustained for one year. This corresponded to increased average monthly prescribing rates from 1.5% before any intervention to 28.7% afterward. ED staff education had no measurable impact on prescribing rates but was associated with increased nursing perceived importance and increased provider confidence in prescribing naloxone.
conclusionsA significant increase in naloxone prescribing rates was achieved after implementation of high-reliability EMR work-aids and staff education. Similar interventions may be key to wider ED staff engagement in harm reduction for patients with OUD.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.