Implementing a text-message-based intervention to increase access to naloxone for patients on chronic opioid therapy

Objective: To implement a text-message-based intervention for primary care patients taking chronic opioid therapy to increase access to naloxone. Design: Retrospective analysis of a hospital quality improvement initiative. Setting: This study was conducted with selected primary care practices affiliated with an academic medical center between March and July 2022. Participants: Patients were eligible for receiving the intervention if they had chronic (≥90 days) opioid use of ≥50 morphine milligram equivalents/day and had not previously opted out of receiving text messages. Interventions: Text messages were sent to patients inquiring about interest in obtaining a naloxone kit, which prompted a pharmacist to contact the patient and provide the medication by mail. Main outcome measures: We examined response rates to text messages and numbers of naloxone kits dispensed. Results: There were 243 patients identified who were sent the text message. Of these, 230 (94.7 percent) had a primary language of English, 150 (61.7 percent) were White, and 57 (23.5 percent) were Black/African American. The mean age was 57.3 years. After receiving the text messages, 64 (26.3 percent) of the 243 patients responded with “unsubscribe.” Thirty-five (14.4 percent) patients responded to the message, and 18 patients (51.4 percent of those who responded or 7.4 percent of all included patients) wanted the medication and were contacted by a pharmacist who filled and mailed the prescription to them. Conclusions: A text-message-based program to provide naloxone to patients with chronic opioid use was feasible. However, fewer than 15 percent of patients responded to the message, and just half of those wanted the medicine.