SAFE – Home Opioid Management Education (SAFE-HOME) in older adults: a naloxone awareness program for home health workers

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Abstract

Background: Older adults (≥65 years) have seen significant increases in opioid overdose deaths. Diversion of older adults’ opioid medication is also a contributor to opioid misuse. Naloxone, an opioid antagonist, saves lives when used for an opioid overdose, yet education on opioid overdose and naloxone access and training for older adults is limited.

Methods: A prospective, interventional training program was created to educate home health workers and their older adult clients on opioid overdose and naloxone utility. The SAFE – Home Opioid Management Education (SAFE-HOME) naloxone awareness program was created to include in-person training with educational handouts around opioid risks and on the importance of naloxone. Home health workers, who provide in-home care and care coordination to older adults in rural Illinois, were trained to educate their clients with the SAFE-HOME program. Older adults were included if they were prescribed an opioid for any indication. Outcomes included change in knowledge of opioids and naloxone, home health worker perception of client knowledge level and naloxone obtainment rates following the educational intervention.

Results: Thirty-five clients completed the SAFE-HOME program. The average knowledge assessment score increased from a baseline of 39.4% (SD 26.8) to 90.6% (SD 12.6, p<0.01). Most home health workers agreed their older adult clients had poor baseline knowledge of naloxone. No clients obtained naloxone due to lack of perceived need and cost barriers.

Conclusion: An educational approach utilizing home health workers as client educators resulted in increased knowledge of opioid risks and naloxone utility amongst older adults.

Keywords: home health worker, naloxone, older adult, opioid overdose.

Citation: McQuade BM, Koronkowski M, Emery-Tiburcio E, Golden R, Jarrett JB. SAFE – Home Opioid Management Education (SAFE-HOME) in older adults: a naloxone awareness program for home health workers. Drugs Context. 2021;10:2021-7-6. https://doi.org/10.7573/dic.2021-7-6

Contributions: BMM: conceptualization, methodology, validation, formal analysis, investigation, resources, data curation, manuscript writing. MK: conceptualization, methodology, validation, resources, manuscript editing and reviewing, visualization, supervision, funding acquisition. EE-T: conceptualization, methodology, validation, resources, manuscript editing and reviewing, visualization, supervision, funding acquisition. RG: conceptualization, methodology, validation, resources, manuscript editing and reviewing, visualization, supervision, funding acquisition. JBJ: conceptualization, methodology, validation, formal analysis, investigation, resources, data curation, manuscript writing, visualization, supervision, project administration, funding acquisition. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole and have given their approval for this version to be published.

Disclosure and potential conflicts of interest: Dr McQuade received individual consulting fees for providing support for Opioid Stewardship (a program sponsored by Centers for Medicare Services to target high-opioid prescribing providers and educate them on tapering, pain alternatives, and overall reduction of opioid prescribing) and received honoraria for speaking at the IHC Annual Convention. Dr Koronkowski received consulting fees from OptumRx. Dr Jarrett received grants from HRSA, SAMHSA, the Coleman Foundation and the Moore Foundation. Dr Jarrett was also employed by CVS Health and received stock through this employment from CVS Health. All other authors declare that they have no conflict of interest relevant to this manuscript. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors is available for download at: https://www.drugsincontext.com/wp-content/uploads/2021/10/dic.2021-7-6-COI.pdf

Acknowledgements: The authors would like to thank Carol Aronson and Marsha Nelson for their collaboration at the Shawnee Health Service and Colleen Bradley, PharmD Candidate, for her contributions to this manuscript.

Funding declaration: The SAFE-HOME project was funded through the Health Resources and Services Administration (HRSA) Geriatric Workforce Enhancement Program (GWEP) [U1QHP28715] as a supplement to the Collaborative Action Team training for Community Health – Older adult Network (CATCH-ON) program.

Copyright: Copyright © 2021 McQuade BM, Koronkowski M, Emery-Tiburcio E, Golden R, Jarrett JB. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0 which allows anyone to copy, distribute and transmit the article provided it is properly attributed in the manner specified below. No commercial use without permission.

Correct attribution: Copyright © 2021 McQuade BM, Koronkowski M, Emery-Tiburcio E, Golden R, Jarrett JB. https://doi.org/10.7573/dic.2021-7-6. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0.

Article URL: https://www.drugsincontext.com/safe-home-opioid-management-education-in-older-adults-a-naloxone-awareness-program-for-home-health-workers

Correspondence: Jennie B Jarrett, University of Illinois at Chicago, College of Pharmacy, 833 S. Wood Street (MC 886), Chicago, IL 60612, USA. Email: jarrett8@uic.edu

Provenance: Invited; externally peer reviewed.

Submitted: 14 July 2021; Accepted: 24 September 2021; Publication date: 15 December 2021.

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