Impact of Naloxone Education on Healthcare Professionals’ Knowledge and Attitudes By Jacqueline Hagarty, Matthew Martin, Michael DeValve, Susan Miller
Abstract Background: Naloxone, a safe opioid overdose reversal agent, is now more accessible in North Carolina through a statewide standing order. However, general awareness about naloxone is low. Previous studies identified healthcare providers’ perceived barriers to prescribing naloxone due to lack of knowledge about naloxone dosage forms for use in the community, worries about encouraging drug abuse, and concern about legal liabilities. The purpose of this study was to determine if a targeted naloxone education program increases knowledge and positive attitudes of health care professionals concerning naloxone use in the community. Methods: Educational sessions were held for healthcare professionals in one region of North Carolina. The Opioid Overdose Knowledge Scale (OOKS) and Opioid Overdose Attitudes Scale (OOAS) were administered before and after each educational session to assess for immediate changes. The mean change in overall pre- and post-test scores were analyzed and compared based on demographic information. Results: One hundred one participants completed surveys. There was a 15% increase in the average knowledge score (33 to 40 out of 45 points, p-value <0.0125), and a 9% increase (106 to 119 out of 140, p-value <0.0167) in the average attitudes scores indicating an increase in readiness and positive attitudes towards naloxone use. Limitations: This study utilized a convenience sample of healthcare professionals who attended the education sessions. Retention of knowledge and attitudes or behavioral changes following education sessions were not measured. Conclusion: Targeted naloxone education is associated with an increase in short-term knowledge and positive attitudes towards naloxone use in the community. North Carolina Pharmacist
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Background According to the Centers for Disease Control and Prevention (CDC), the amount of opioid overdose deaths quadrupled from 1999 to 2015.1 Opioids (opioid analgesics and heroin) accounted for 28,647 fatalities in 2014, or 61% of all drug overdose deaths.2 Over 1300 of these overdose deaths occurred in North Carolina.2 The United States attempted to address the source of the problem with prescription monitoring programs and suggested daily limits of opioids. Some community organizations are focused on preventing harmful consequences of drug use, such as criminalization, incarceration, spread of HIV and hepatitis, and death from overdose.3 Naloxone is a safe opioid reversal agent; it is one harm-reduction strategy increasingly used by first responders and laypeople in the community to address overdose situations in a timely manner.3 Intranasal and injectable dosage forms of take-home naloxone are indicated for layperson use in the community.4 North Carolina joined other states in efforts to make naloxone more accessible by granting emergency responders and police departments access to naloxone in 2010, and further expanded access to patients by allowing preventative distribution with a prescription in 2015.5 In June 2016, the North Carolina State Health Director signed a statewide standing order allowing pharmacists to dispense naloxone to anyone in need.5 Prescriptions can also be dispensed to a third party, such as a friend or family member of someone at risk.5 Despite the increased access to naloxone across the country, recent evidence suggests that there are many barriers that prevent healthcare professionals from prescribing and dispensing take-home naloxone. Physicians from varying specialties across the United States (including internal medicine, family medicine, pain management, general practice, and many more), Volume 99 Number 1 Winter 2018
