Increasing naloxone prescribing in primary care: a quality improvement project

Background Without access to naloxone, the risk of a fatal opioid overdose significantly increases. Although naloxone is now available over the counter, prescribing it within primary care remains a critical strategy to expand distribution and provide targeted overdose education to vulnerable populations.Methods Transformative learning theory guided this quality improvement project to improve naloxone co-prescribing. The intervention was structured around the theory’s core elements – critical reflection, discourse, and behavioral adaptation. Providers first engaged in self-assessment of their baseline prescribing patterns, prompting reflection on assumptions about naloxone eligibility. An interactive educational session then facilitated inquiry and validation of new perspectives on opioid safety. Case-based discussion supported application of revised understandings to clinical scenarios.Results Together, these components fostered a shift in provider mind-set, reinforcing naloxone co-prescribing as a standard practice and supporting sustained improvements in prescribing behavior. Following the intervention, providers reported reduced fears regarding naloxone prescribing. Additionally, naloxone prescribing rates increased.Conclusion Naloxone prescribing improved after targeted provider education and changes in attitudes, specifically less fear of consequences, toward prescribing naloxone were addressed. The application of a transformative learning framework is a valuable strategy for promoting naloxone prescribing and enhancing opioid overdose prevention efforts to improve patient safety.