One-on-one care management and procurement of Naloxone for ambulatory use.

Background: Morbidity and mortality from prescription opioids has reached unprecedented levels. Opioids remain part of chronic pain treatment in primary care. This study was designed to determine whether one-on-one care management increases procurement of Naloxone, an opioid antagonist shown to reduce morbidity and mortality in opioid overdoses. Methods: Participants included all patients ≥18 years enrolled in a primary care-based chronic pain management program and who were prescribed a daily dose of opioids for treatment of chronic pain. In total, 153 patients chose to participate. Each had a 1 h one-on-one education meeting with a registered nurse. Results: Among the enrolled, eight patients (5.2%) had procured Naloxone prior to intervention. Overall, 31 additional patients (20.2%) procured Naloxone after intervention, a 288% relative improvement in the attainment of Naloxone (P < 0.0001) (χ2 = 29.032 with 1 degree freedom). Of the 114 participants who never procured Naloxone, 69.3% believed it was unnecessary, 20% forgot about Naloxone, 8% said it was cost prohibitive, 3.5% had access concerns and 0.9% had concerns about side effects. Conclusion: Direct one-on-one nurse care management sessions were associated with an increased procurement of Naloxone in a primary care-based pain management program. A significant number of patients believed Naloxone was unnecessary after the intervention.

Patient and Public Information delivery through NHS library and knowledge services: how Knowledge for Healthcare changed the landscape.

Health care library and knowledge services (LKS) are now expected to contribute to the provision of Patient and Public Information (PPI). The challenges of an ageing population, prevalence of long-term conditions and the encouragement of patients to self manage give added impetus. The Knowledge for Health care PPI Task and Finish Groups developed strategic partnerships with national organizations and produced a suite of resources to support LKS staff. Outputs include guidance, workshop materials, an Ideas Bank and Guide to NHS Choices. The work of the PPI Task and Finish groups will continue to support staff as they develop activities and evidence its impact.