Effectiveness of an Educational Intervention to Increase Naloxone Prescribing Practices Among Rural Providers to Decrease the Death Rate from Opiate Overdose

Background: The death rate from opiate overdoses has exploded into what health officials call an epidemic. Nationwide, over 42,000 opiate overdose deaths occurred in 2016 with 40% of those being attributed to prescribed opiates. Between 2015-2016, there was a 10% increase in the death rate from prescription opioids (Centers for Disease Control, (CDC), 2017). Local problem: The death rate in Utah from opiate overdose has quadrupled since the turn of the century. In 2000, there were 139 deaths from opiate overdose, in 2017 that number ballooned into 635 (Utah Department of Health, 2017). Rural communities are particularly vulnerable to deaths from opiate overdose (Faul, Dailey, Sugerman, Levvy & Paulozzi, 2015). Carbon, Emery, and Grand counties are experiencing some of the highest rates of opiate overdose deaths (47.3 per 100,000) compared to the rest of the state of Utah (13.2 per 100,000). Method/Intervention: An educational intervention was delivered in person to 16 prescribing providers in 3 different rural settings via a power point on naloxone pharmacology and prescribing. Measures: A pre/post-test was used to measure the intervention's effectiveness. A follow-up survey was emailed 3 months later to assess whether or not the prescribers had increased their naloxone prescribing habits. Results: Results were analyzed using paired-t test and descriptive statistics and are as follows: the average difference of improvement from pre to post-test score was 11% (t(14)=-3.84, p 0.0017, p value < 0.05) indicating the educational intervention was effective in increasing the providers' knowledge. Twelve participants agreed to receive the follow-up survey, and 5 responded with results as follows: 5/5 reported that the educational intervention increased awareness of the importance in prescribing Naloxone to individuals and/or third parties at risk of experiencing/witnessing an opiate overdose in order to reduce the death rate from opiate overdoses, 3/5 participants reported distributing donated naloxone kits to patients or third parties at risk if experiencing/witnessing an opiate overdose, and 3/5 participants reported increasing their naloxone prescribing habits since receiving the educational intervention. Conclusion: An educational intervention increased providers' knowledge surrounding naloxone prescribing for patients and third parties at high risk for experiencing/witnessing opiate overdose, led to enhanced awareness of the importance of prescribing naloxone to help reduce the death rate from opiate overdose, and increased 3 of the providers' naloxone prescribing habits.