Electronic Health Record Alert Improves Naloxone Coprescribing for Cancer Patients

Strategic Insights -

Aurora, Colorado residents may recall the crucial role electronic health records (EHRs) play in patient care. A recent project in an outpatient medical oncology clinic in the Mountain West region of the US demonstrated the effectiveness of implementing EHR alerts to increase naloxone coprescribing rates for patients with cancer at risk for opioid overdose. The study, conducted by researchers at the University of Colorado Anschutz Medical Campus, found that the primary outcome measure, a 29 percentage point increase from baseline, was achieved with a statistically significant odds ratio of 6.57.

Key Takeaways:

  • The Centers for Disease Control and Prevention and U.S. Public Health Service recommend that clinicians prioritize coprescribing take-home naloxone (THN) for patients with cancer receiving opioids in high doses or in the presence of a concomitant high-risk medication.
  • The coprescribing rate for opioid prescriptions totaling 100 morphine milligram equivalents (MME) per day was 38% at the end of the post-intervention period, a 29 percentage point increase from baseline (odds ratio [OR] = 6.57, 95% confidence interval [CI] = 1.85-23.39, = .003).
  • The coprescribing rate for opioid prescriptions with a high-risk medication was 57% at completion of the project, a 53 percentage point increase from baseline (OR = 30.67, 95% CI = 8.91-105.59).
  • An EHR alert was developed to notify the provider when eligibility criteria were met, prompting them to coprescribe THN.
  • The study concluded that the project established the practicality and success of THN coprescribing alert implementation and can be utilized as a roadmap for other practices to achieve safe opioid prescribing for patients with cancer.

Statistics:

  • 100 MME per day opioid prescriptions were eligible for inclusion in the study ( = 224).
  • The primary outcome measure, a 29 percentage point increase from baseline, was achieved with a statistically significant odds ratio of 6.57.
  • 38% of opioid prescriptions totaling 100 MME per day had THN coprescribed at the end of the post-intervention period.
  • 57% of opioid prescriptions with a high-risk medication had THN coprescribed at completion of the project.
  • The study was conducted in an outpatient medical oncology clinic in the Mountain West region of the US.

Sources:

  • NewsRx. New Findings on Prescription Opioids Discussed by Researchers at University of Colorado Anschutz Medical Campus (Implementation of an Electronic Health Record Alert to Improve Naloxone Coprescribing for Adult Patients With Cancer at Risk for ...). Cancer Weekly. October 21, 2025; p 492.
  • Implementation of an Electronic Health Record Alert to Improve Naloxone Coprescribing for Adult Patients With Cancer at Risk for Opioid Overdose. Journal of the Advanced Practitioner in Oncology, 2025;16(7):1-9.