The Impact of a Web-Based Naloxone Intervention Under Standing Orders to Patients Prescribed Chronic Opioid Therapy

This is a patient level randomized study of a targeted, web-based overdose prevention and
naloxone intervention for patients prescribed chronic opioid therapy. This study will be
conducted in a health system which has implemented naloxone standing orders. Adults
prescribed chronic opioid therapy will be identified in the electronic health record,
outreached, and recruited for participation. Once enrolled, participants will be randomized
to usual care or the intervention. The web-based intervention is an animated video which
provides education on what is an opioid overdose, how to prevent and recognize an opioid
overdose, and how to respond with naloxone. This video also encourages patients to pick up
naloxone from a pharmacy under standing orders. Participants will be given knowledge and risk
surveys over the follow-up. The primary outcome is opioid risk behavior. Secondary outcomes
include knowledge about overdose and naloxone, substance use, and pain intensity. Patients
will also be followed in the electronic health record for naloxone dispensings, changes in
opioid dose, aberrant urine toxicology results, and overdose events.

Inclusion Criteria:

- 18 years of age or greater

- Prescribed chronic opioid therapy

- Have a health plan which covers the formulation of naloxone available at the pharmacy
they received their opioid prescriptions from.

Exclusion Criteria:

- Non-English speaking, hospice enrollment, do-not-resuscitate order, no internet access