SHM Converge Scientific Abstract ePoster Gallery-Sustainability of Clinical Decision Support Intended to Increase Naloxone Co-Prescription

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This study examined whether an electronic health record (EHR) clinical decision support tool at Nebraska Medicine sustainably increased naloxone co-prescribing with outpatient opioid prescriptions.<br /><br />Opioid overdose remains a major cause of death in the U.S., and naloxone is a key harm-reduction medication. Although earlier work showed that EHR prompts could increase naloxone prescribing, the long-term effect had not been evaluated.<br /><br />Researchers reviewed 6 years of prescribing data: 36 months before and 36 months after implementation of the naloxone decision support in August 2021. They analyzed all outpatient opioid prescriptions, including those written at hospital discharge, and measured both prescription-level and patient-level naloxone co-prescription rates.<br /><br />Results showed a large and sustained increase after implementation. Before the tool, 193,807 opioid prescriptions were written for 70,165 patients, and only 2,305 prescriptions (1.2%) included naloxone, affecting 302 patients (0.43%). After implementation, 191,051 opioid prescriptions were written for 67,557 patients, and 61,763 prescriptions (32.3%) included naloxone, affecting 15,696 patients (23.2%).<br /><br />A table focusing on prescriptions at or above 50 MME/day also showed improvement, with naloxone co-prescribing rising from 2.7% pre-implementation to 55.7% post-implementation.<br /><br />Overall, the findings suggest that EHR-based clinical decision support can produce a durable increase in naloxone co-prescribing at a large health system, improving both prescription-level and patient-level coverage.

Asset Subtitle

Nicholas Weiland

Meta Tag

Author List Justin Birge, Nicholas Weiland

Category Research

Concept Naloxone

Concept Co-prescribing

Concept Opioid Prescription

Concept Harm Reduction

Concept Electronic Health Record

Distinguished Non-Finalist

Presenter Organization Nebraska Medicine

Presenting Author Nicholas Weiland

Track Quality Improvement

Keywords

naloxone

opioid prescriptions

electronic health record

clinical decision support

co-prescribing

opioid overdose

harm reduction

outpatient prescribing

prescription rates

Nebraska Medicine

Naloxone

Co-prescribing

Opioid Prescription

Harm Reduction

Electronic Health Record