How CHOP increased naloxone co-prescribing from 3% to 84%: Study

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Children’s Hospital of Philadelphia increased average monthly naloxone, known as Narcan, co-prescribing for patients receiving outpatient opioid prescriptions from 3% to 84.1% through an enterprisewide quality improvement initiative, according to a study published June 16 in The Journal of Pediatrics.

The initiative was implemented between October 2023 and June 2025 in three phases, using an EHR-based automated alert to co-prescribe naloxone along with education for providers, nurses, pharmacists, patients and families.

Here are four things to know:

  1. In 2023, less than 3% of patients prescribed opioids at discharge from CHOP also received a naloxone prescription. The initiative, part of CHOP’s Empower Program, aimed to increase co-prescribing to at least 80% for eligible patients.
  2. Nearly 60% of naloxone prescriptions were filled through CHOP pharmacies. The team also partnered with the outpatient pharmacy to monitor out-of-pocket costs, identify financial barriers and expand access to a Pennsylvania state discount program previously available only to adult patients.
  3. Early feedback showed that perceived stigma and costs were barriers to dispensing, but 81.8% of providers reported that naloxone was easy to prescribe and 86.4% reported high levels of comfort when offering the medication to families.
  4. Researchers found EHR-based prompts combined with education for providers increased naloxone co-prescribing across the large pediatric health system.  

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