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Peer-reviewedCC BY-NC 4.0Drug Safety

Incidence of Naloxone-Use Before and After Implementing Opioid Safety Measures for Patients Hospitalised on General Wards in a Swiss University Hospital

  • Anja Jungo1,2
  • Kanchan Dongre2,3
  • Delia Halbeisen4
  • Tobias Schneider5
  • Sibylle Chettata5
  • Niklaus Gygli6
  • Murat Bilici7
  • Christoph R. Meier1,4
  • Anne B. Leuppi-Taegtmeyer2,3
7 affiliations
  1. 1Department of Pharmaceutical Science, University of Basel, Basel, Switzerland
  2. 2Department of Patient Safety, Medical Directorate, University Hospital Basel, Basel, Switzerland
  3. 3Department of Clinical Research, University of Basel, Basel, Switzerland
  4. 4Hospital Pharmacy, University Hospital Basel, Basel, Switzerland
  5. 5Clinic for Anaesthesia, Intermediate Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, Basel, Switzerland
  6. 6Department of Nursing, Medical Directorate, University Hospital Basel, Basel, Switzerland
  7. 7Department of Quality Management, Medical Directorate, University Hospital Basel, Basel, Switzerland
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Abstract

Background: Opioids are high-risk medications that in overdose can lead to severe life-threatening or fatal adverse drug events. Inadvertent overdose is often the cause of opioid intoxication in hospitals. We introduced digital weight-based as-needed morphine and hydromorphone order sets at our hospital in November 2020 to prevent such adverse events. Naloxone given to reverse life-threatening opioid intoxication (LTOI) is a marker for these events in patient records.

Aim: The main aim was to ascertain the incidence of opioid-treated patients requiring naloxone for the management of LTOI on general wards before and after implementation of the order sets.

Methods: This investigator-driven, retrospective, observational, single-centre cohort study investigated naloxone administrations for LTOIs per 1000 opioid-treated patients, and per 1000 inpatients on general wards between 2019 and 2024 at the University Hospital Basel (USB). Prescription data and electronic hospital records were reviewed.

Results: During the study period, a total of 78,438 patient cases received prescription opioids, of which 149 required naloxone for LTOIs. The incidence of naloxone-treated LTOIs per 1000 opioid treated patients was 3.21 prior to the introduction of the order sets and declined to 1.46 four years later (55% reduction, p = 0.002). There were 181,314 inpatients during the study period. The incidence of naloxone per 1000 inpatients was 1.14 before and 0.64 four years after the introduction of the order sets (44% reduction, p = 0.023).

Conclusion: We observed a significant reduction in the incidence of naloxone use for LTOI following the introduction of digital order sets for as-required morphine and hydromorphone indicating their effect to help promote safe opioid use and to improve patient safety in our hospital.

Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s40264-026-01679-1.

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Cite

BibTeXRIS
BibTeX
@article{jungo2026incidence,
  title = {{Incidence of Naloxone-Use Before and After Implementing Opioid Safety Measures for Patients Hospitalised on General Wards in a Swiss University Hospital}},
  author = {Anja Jungo and Kanchan Dongre and Delia Halbeisen and Tobias Schneider and Sibylle Chettata and Niklaus Gygli and Murat Bilici and Christoph R. Meier and Anne B. Leuppi-Taegtmeyer},
  journal = {Drug Safety},
  year = {2026},
  month = jun,
  doi = {10.1007/s40264-026-01679-1},
  url = {https://doi.org/10.1007/s40264-026-01679-1},
  note = {CC BY-NC 4.0},
}
RIS
TY  - JOUR
TI  - Incidence of Naloxone-Use Before and After Implementing Opioid Safety Measures for Patients Hospitalised on General Wards in a Swiss University Hospital
AU  - Anja Jungo
AU  - Kanchan Dongre
AU  - Delia Halbeisen
AU  - Tobias Schneider
AU  - Sibylle Chettata
AU  - Niklaus Gygli
AU  - Murat Bilici
AU  - Christoph R. Meier
AU  - Anne B. Leuppi-Taegtmeyer
PY  - 2026
DA  - 2026/06/02
JO  - Drug Safety
DO  - 10.1007/s40264-026-01679-1
UR  - https://doi.org/10.1007/s40264-026-01679-1
AB  - Background: Opioids are high-risk medications that in overdose can lead to severe life-threatening or fatal adverse drug events. Inadvertent overdose is often the cause of opioid intoxication in hospitals. We introduced digital weight-based as-needed morphine and hydromorphone order sets at our hospital in November 2020 to prevent such adverse events. Naloxone given to reverse life-threatening opioid intoxication (LTOI) is a marker for these events in patient records.  Aim: The main aim was to ascertain the incidence of opioid-treated patients requiring naloxone for the management of LTOI on general wards before and after implementation of the order sets.  Methods: This investigator-driven, retrospective, observational, single-centre cohort study investigated naloxone administrations for LTOIs per 1000 opioid-treated patients, and per 1000 inpatients on general wards between 2019 and 2024 at the University Hospital Basel (USB). Prescription data and electronic hospital records were reviewed.  Results: During the study period, a total of 78,438 patient cases received prescription opioids, of which 149 required naloxone for LTOIs. The incidence of naloxone-treated LTOIs per 1000 opioid treated patients was 3.21 prior to the introduction of the order sets and declined to 1.46 four years later (55% reduction, p = 0.002). There were 181,314 inpatients during the study period. The incidence of naloxone per 1000 inpatients was 1.14 before and 0.64 four years after the introduction of the order sets (44% reduction, p = 0.023).  Conclusion: We observed a significant reduction in the incidence of naloxone use for LTOI following the introduction of digital order sets for as-required morphine and hydromorphone indicating their effect to help promote safe opioid use and to improve patient safety in our hospital.  Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s40264-026-01679-1.
SN  - 0114-5916
SN  - 1179-1942
ER  -