Drug safety · 2026
Incidence of Naloxone-Use Before and After Implementing Opioid Safety Measures for Patients Hospitalised on General Wards in a Swiss University Hospital.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Jungo Anja, Dongre Kanchan, Halbeisen Delia, Schneider Tobias, Chettata Sibylle, Gygli Niklaus, Bilici Murat, Meier Christoph R, Leuppi-Taegtmeyer Anne B
Аннотация
BACKGROUND: Opioids are high-risk medications that in overdose can lead to severe life-threatening or fatal adverse drug events. Inadvertent overdose is often the cause of opioid intoxication in hospitals. We introduced digital weight-based as-needed morphine and hydromorphone order sets at our hospital in November 2020 to prevent such adverse events. Naloxone given to reverse life-threatening opioid intoxication (LTOI) is a marker for these events in patient records.
AIM: The main aim was to ascertain the incidence of opioid-treated patients requiring naloxone for the management of LTOI on general wards before and after implementation of the order sets.
METHODS: This investigator-driven, retrospective, observational, single-centre cohort study investigated naloxone administrations for LTOIs per 1000 opioid-treated patients, and per 1000 inpatients on general wards between 2019 and 2024 at the University Hospital Basel (USB). Prescription data and electronic hospital records were reviewed.
RESULTS: During the study period, a total of 78,438 patient cases received prescription opioids, of which 149 required naloxone for LTOIs. The incidence of naloxone-treated LTOIs per 1000 opioid treated patients was 3.21 prior to the introduction of the order sets and declined to 1.46 four years later (55% reduction, p = 0.002). There were 181,314 inpatients during the study period. The incidence of naloxone per 1000 inpatients was 1.14 before and 0.64 four years after the introduction of the order sets (44% reduction, p = 0.023).
CONCLUSION: We observed a significant reduction in the incidence of naloxone use for LTOI following the introduction of digital order sets for as-required morphine and hydromorphone indicating their effect to help promote safe opioid use and to improve patient safety in our hospital.
AIM: The main aim was to ascertain the incidence of opioid-treated patients requiring naloxone for the management of LTOI on general wards before and after implementation of the order sets.
METHODS: This investigator-driven, retrospective, observational, single-centre cohort study investigated naloxone administrations for LTOIs per 1000 opioid-treated patients, and per 1000 inpatients on general wards between 2019 and 2024 at the University Hospital Basel (USB). Prescription data and electronic hospital records were reviewed.
RESULTS: During the study period, a total of 78,438 patient cases received prescription opioids, of which 149 required naloxone for LTOIs. The incidence of naloxone-treated LTOIs per 1000 opioid treated patients was 3.21 prior to the introduction of the order sets and declined to 1.46 four years later (55% reduction, p = 0.002). There were 181,314 inpatients during the study period. The incidence of naloxone per 1000 inpatients was 1.14 before and 0.64 four years after the introduction of the order sets (44% reduction, p = 0.023).
CONCLUSION: We observed a significant reduction in the incidence of naloxone use for LTOI following the introduction of digital order sets for as-required morphine and hydromorphone indicating their effect to help promote safe opioid use and to improve patient safety in our hospital.