Internal Medicine Resident Knowledge, Attitudes, and Barriers to Naloxone Prescription in Hospital and Clinic Settings

Abstract

Medicine residents are aware of naloxone and willing to prescribe it to at-risk patients. Due to decreased applied knowledge and limited self-efficacy, few residents have prescribed naloxone in the past. In order to improve rates of physician prescribing, initiatives must help physicians better assess risk of overdose and improve prescribing self-efficacy.

Acceptability and feasibility of naloxone prescribing in primary care settings: A systematic review

“…Articles were categorized as either pertaining to naloxone prescribing acceptability (N=10), 16–25 feasibility (N=5), 26–30 or both (N=2), 31,32 and also categorized as including perspectives from prescribers (N=14), 16,18–22,24–31 patients (N=2), 17,23 or both (N=1). 32 The studies had broad geographic scope within the US, covering the Northeast (N=4), Midwest (N=1), Southwest (N=5), West (N=5), and national (N=2).…”

“…16,18,20,22,24,31 The two earliest published articles reported the highest degree of provider resistance to naloxone prescribing. One study, published in 2003, stated that 37% of respondents would not be willing to prescribe naloxone 20 while another study, published in 2006, stated that 54% of respondents would not prescribe naloxone.…”

“…18 In contrast, the two most recent studies, published in 2016 and 2017, indicated that 90% and 99% of prescribers were willing to prescribe naloxone, respectively. 16,24 …”

“…26 In addition, Wilson, et al, showed that most resident physicians in their sample (88%) believed it was their responsibility to educate their patients on overdose and naloxone utilization. 24 …”

Acceptability of Naloxone Co-Prescription Among Primary Care Providers Treating Patients on Long-Term Opioid Therapy for Pain

“…and logistical prescribing difficulties. [9][10][11][12][13] No studies to date have evaluated the actual experience of providers prescribing naloxone to patients.…”