Children's Hospital of Philadelphia Increases Naloxone Co-Prescribing for Opioid Prescriptions

The Children's Hospital of Philadelphia (CHOP) has implemented a widespread initiative that significantly boosted the co-prescribing of naloxone alongside outpatient opioid prescriptions. Previously, less than 3% of patients receiving opioid prescriptions upon discharge also received naloxone. Following the new program, this figure now exceeds 80%, as detailed in a study published in The Journal of Pediatrics, aiming to reduce opioid overdose risks.

A multidisciplinary team at CHOP, comprising physicians, pharmacists, and nurses, developed a standardized approach integrated into the hospital's electronic health record (EHR) system. This was coupled with educational efforts for healthcare professionals, patients, and their families. The objective was to ensure all children and adolescents prescribed outpatient opioids also received naloxone, a life-saving medication for overdose situations.

The initiative, part of the hospital's EMPOWER program, has markedly improved opioid safety practices. While prior studies indicated low naloxone usage for infants and children under five, children and adolescents prescribed opioids for longer treatment periods are at significant risk. Including naloxone on prescription lists is a crucial step in enhancing the safety of pediatric patients and aligns with recommendations from the U.S. Food and Drug Administration (FDA).

The study found that perceived stigma and medication costs remained barriers, yet nearly 60% of prescriptions were dispensed through CHOP's own pharmacies. As part of the initiative, access to affordable medication was also improved through a state discount program previously available only to adults. CHOP views this framework as a scalable model for promoting safer opioid management at other children's hospitals.