Group Visits for Overdose Education and Naloxone Distribution in Primary Care: A Pilot Quality Improvement Initiative.

Objective: Opioid prescribing for chronic pain significantly contributes to opioid overdose deaths in the United States. Naloxone as a take-home antidote to opioid overdose is underutilized and has not been evaluated in the high-risk chronic pain population. The objective was to increase overdose education and naloxone distribution (OEND) to high-risk patients on long-term opioid therapy for pain by utilizing group visits in primary care.

Design: Quality improvement intervention among two primary care clinics.

Setting: A large, academic facility within the Veterans Health Administration.

Subjects: Patients prescribed ≥100 mg morphine-equivalent daily dose or coprescribed opioids and benzodiazepines.

Methods: One clinic provided usual care with respect to OEND; another clinic encouraged attendance at an OEND group visit to all of its high-risk patients.

Results: We used attendance at group visits, prescriptions of naloxone issued, and patient satisfaction scores to evaluate this format of OEND.

Key Results: Group OEND visits resulted in significantly more naloxone prescriptions than usual care. At these group visits, patients were engaged, valued the experience, and all requested a prescription for the naloxone kit.

Conclusion: This quality improvement pilot study suggests that OEND group visits are a promising model of care.