(1319) Assessing Geriatric Perceptions of Naloxone After a Pharmacist-led Consultation

Objectives: The primary objective of this study is to assess the baseline knowledge and perceptions of naloxone in a geriatric population. Secondary objectives are to evaluate the impact of a pharmacist-led naloxone consultation on willingness to obtain naloxone and identify barriers to obtaining naloxone in those who decline it. The Centers for Disease Control and Prevention reports that 50,943 overdose deaths occurred in 2021 with only 20.2% of those individuals having had naloxone administered. It is estimated that only one naloxone prescription is dispensed for every 70 high-dose opioid prescriptions. While it is important to educate and dispense naloxone for all eligible patients, the elderly population is often overlooked. It was found that naloxone prescribing peaked in the age group of 46-55 with a low rate of co-prescribing naloxone in individuals over the age of 65. Naloxone blocks effects of opioids and can be lifesaving for patients experiencing opioid overdose. It can be administered intranasally, intramuscularly, subcutaneously, or intravenously. Currently all 50 states and DC have pathways allowing pharmacists to dispense naloxone without a patient specific prescription. Buncombe County, North Carolina has expanded its impact on harm reduction through the Opioid Settlement Fund. The county has resources for syringe sales, naloxone distribution, and harm reduction supplies with plans to expand their reach.

Methods: This cross-sectional study will be performed at a single location of a chain pharmacy in western North Carolina. This study will engage patients of the pharmacy who are 65 years or older, have an active prescription for an opioid medication, and do not have an active naloxone prescription on file at the pharmacy. Patients less than 65 years of age, without an active opioid prescription, or who received naloxone within the past 12 months will be excluded from this study. Patients will be identified by running a report in the pharmacy dispensing system to identify patients meeting inclusion criteria. Patients identified by the report will be reviewed to confirm they meet naloxone eligibility criteria per the North Carolina State Health Director’s Naloxone Standing Order for Pharmacists. If a patient is eligible for naloxone, the pharmacy resident or pharmacy staff member will contact the patient by phone and discuss what naloxone is, how it is used, its benefits, and will offer to fill the prescription for the patient. If the offer to fill is accepted, the resident will process the prescription under the statewide standing order, determine the cost and inform patient. A flyer will be available to give to patient detailing administration and proper use of naloxone. Ten days following fill of naloxone, the patient’s profile will be checked to see if the prescription was picked up by the patient. If the patient declines the fill of naloxone, their reason of declining will then be asked and documented. Data will be documented on a password protected excel spreadsheet. Descriptive statistics will be utilized for data analysis.

Results: Institutional Review Board approval is anticipated in October 2023. Data collection will occur from November 2023 through January 2024. Data analysis will occur in February 2024.

Conclusions: This research will assess the impact of educating and prescribing naloxone to geriatric patients in a chain pharmacy location. This study may provide insight to ways of communicating the importance of naloxone, a life-saving medication, to geriatric patients with an opioid prescription, a high-risk patient population. One goal within this research is to expand naloxone prescribing to include a high-risk population that is often overlooked.