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{
    "pk": 47387,
    "title": "Development of a Low-Barrier, Reimbursable Take-Home Naloxone Program at a Regional Health System",
    "subtitle": null,
    "abstract": "<p><strong>Introduction:</strong> Take-home naloxone (THN) programs in emergency departments (ED) can reduce opioid overdose deaths by providing naloxone directly to at-risk patients before discharge. However, sustainable models that integrate reimbursement and workflow alignment remain limited.</p>\n<p><strong>Methods:</strong> A reimbursable ED-led THN program was developed across a large regional health system. The program used electronic health record (EHR)–integrated ordering, on-site kit dispensing, and third-party insurance billing when available. Kits were stocked in automated medication dispensing systems and supplemented by city-provided stock for uninsured patients. Pilot outcomes included kits dispensed and reimbursement rates across eight participating EDs.</p>\n<p><strong>Results:</strong> A total of 2,520 naloxone kits were dispensed across eight EDs between January 2019–December 2024, with a total of 6,551 encounters with decision support prompting naloxone ordering (31.6% of eligible). The proportion of kits reimbursed by insurance rose from 46% in 2019 to 95% by 2025. In total, 89.9% of kits were reimbursed either by insurance or public supply (the rest paid by the hospital system). Kit distribution grew from 99 in 2019 to 702 in 2024, reflecting expanded site participation, improved workflows, and greater staff engagement.</p>\n<p><strong>Conclusion: </strong>A reimbursable ED-led naloxone program can increase access to life-saving medication for patients at risk of opioid overdose. Integrating take-home naloxone distribution into EHR workflows, leveraging insurance billing, and partnering with public health agencies offers a sustainable, low-barrier model that other health systems can adopt.</p>",
    "language": "eng",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "naloxone"
        },
        {
            "word": "take home naloxone"
        },
        {
            "word": "Harm reduction"
        },
        {
            "word": "opioid overdose"
        },
        {
            "word": "Low Barrier Care"
        },
        {
            "word": "Medication Dispensing from ED"
        }
    ],
    "section": "Original Research (Limit 4000 words)",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/00c1120v",
    "frozenauthors": [
        {
            "first_name": "Kory",
            "middle_name": "S.",
            "last_name": "London",
            "name_suffix": "",
            "institution": "Thomas Jefferson University, Department of Emergency Medicine, Philadelphia, Pennsylvania",
            "department": ""
        },
        {
            "first_name": "Sejal",
            "middle_name": "",
            "last_name": "Patel",
            "name_suffix": "",
            "institution": "Thomas Jefferson University, Department of Pharmacy, Philadelphia, Pennsylvania",
            "department": ""
        },
        {
            "first_name": "Drew",
            "middle_name": "",
            "last_name": "Lockstein",
            "name_suffix": "",
            "institution": "Thomas Jefferson University, Department of Pharmacy, Philadelphia, Pennsylvania",
            "department": ""
        },
        {
            "first_name": "Jamal",
            "middle_name": "",
            "last_name": "Rashid",
            "name_suffix": "",
            "institution": "Thomas Jefferson University, Department of Pharmacy, Philadelphia, Pennsylvania",
            "department": ""
        },
        {
            "first_name": "Richard",
            "middle_name": "",
            "last_name": "Pacitti",
            "name_suffix": "",
            "institution": "Thomas Jefferson University, Department of Pharmacy, Philadelphia, Pennsylvania",
            "department": ""
        },
        {
            "first_name": "TaReva",
            "middle_name": "",
            "last_name": "Warrick-Stone",
            "name_suffix": "",
            "institution": "Thomas Jefferson University, Department of Hospital Medicine, Philadelphia, Pennsylvania",
            "department": ""
        },
        {
            "first_name": "Frederick",
            "middle_name": "",
            "last_name": "Randolph",
            "name_suffix": "",
            "institution": "Thomas Jefferson University, Department of Emergency Medicine, Philadelphia, Pennsylvania",
            "department": ""
        },
        {
            "first_name": "Alan",
            "middle_name": "",
            "last_name": "Cherney",
            "name_suffix": "",
            "institution": "Thomas Jefferson University, Department of Emergency Medicine, Philadelphia, Pennsylvania",
            "department": ""
        },
        {
            "first_name": "Karen",
            "middle_name": "",
            "last_name": "Alexander",
            "name_suffix": "",
            "institution": "Thomas Jefferson University, College of Nursing, Philadelphia, Pennsylvania",
            "department": ""
        },
        {
            "first_name": "Megan",
            "middle_name": "",
            "last_name": "Reed",
            "name_suffix": "",
            "institution": "Thomas Jefferson University, College of Nursing, Philadelphia, Pennsylvania",
            "department": ""
        }
    ],
    "date_submitted": "2025-05-10T03:44:25.845000Z",
    "date_accepted": "2025-07-24T21:36:56.441000Z",
    "date_published": "2025-11-18T14:51:00Z",
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            "path": "https://journalpub.escholarship.org/westjem/article/47387/galley/43165/download/"
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}