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Take-Home Naloxone Program Implementation: Lessons Learned From Seven Chicago-Area Hospitals - 20/08/20

Doi : 10.1016/j.annemergmed.2020.02.013 
Vidya Eswaran, MD a, Katherine C. Allen, PharmD a, Diana C. Bottari, DO b, Jennifer A. Splawski, PharmD c, Sukheer Bains, MD d, Steven E. Aks, DO e, f, Henry D. Swoboda, MD f, g, P. Quincy Moore, MD h, Tran H. Tran, PharmD i, Elizabeth Salisbury-Afshar, MD, MPH j, Patrick M. Lank, MD, MS a, f, Danielle M. McCarthy, MD, MS a, Howard S. Kim, MD, MS a,
a Department of Emergency Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 
b Division of Pediatric Pain and Sedation, Department of Pediatrics, Advocate Children’s Hospital, Oak Lawn, IL 
c Department of Pharmacy, Loyola Medicine–MacNeal Hospital, Berwyn, IL 
d Department of Emergency Medicine, University of Illinois College of Medicine, Chicago, IL 
e Department of Emergency Medicine, Cook County Health, Chicago, IL 
f Toxikon Consortium, Chicago, IL 
g Department of Emergency Medicine, Rush University School of Medicine, Chicago, IL 
h Section of Emergency Medicine, Department of Medicine, University of Chicago Pritzker School of Medicine, Chicago, IL 
i Department of Pharmacy Practice, Midwestern University College of Pharmacy, Downers Grove, IL 
j Center for Addiction Research and Effective Solutions, American Institutes for Research, Chicago, IL 

Corresponding Author.

Abstract

Despite consensus recommendations from the American College of Emergency Physicians (ACEP), the Centers for Disease Control and Prevention, and the surgeon general to dispense naloxone to discharged ED patients at risk for opioid overdose, there remain numerous logistic, financial, and administrative barriers to implementing “take-home naloxone” programs at individual hospitals. This article describes the recent collective experience of 7 Chicago-area hospitals in implementing take-home naloxone programs. We highlight key barriers, such as hesitancy from hospital administrators, lack of familiarity with relevant rules and regulations in regard to medication dispensing, and inability to secure a supply of naloxone for dispensing. We also highlight common facilitators of success, such as early identification of a “C-suite” champion and the formation of a multidisciplinary team of program leaders. Finally, we provide recommendations that will assist emergency departments planning to implement their own take-home naloxone programs and will inform policymakers of specific needs that may facilitate dissemination of naloxone to the public.

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 Supervising editor: Richard C. Dart, MD, PhD. Specific detailed information about possible conflict of interest for individual editors is available at editors.
 Authorship: All authors attest to meeting the four ICMJE.org authorship criteria: (1) Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; AND (2) Drafting the work or revising it critically for important intellectual content; AND (3) Final approval of the version to be published; AND (4) Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
 Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org). This work was supported indirectly by a grant from the Otho S. A. Sprague Memorial Institute and the Illinois Public Health Institute.


© 2020  American College of Emergency Physicians. Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 76 - N° 3

P. 318-327 - septembre 2020 Retour au numéro
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