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“Bad Reaction” More Acceptable to Rural Caregivers than ‘Overdose,’ Study Finds

Jolynn Tumolo

Rural caregivers of patients who take prescription opioids prefer the term “bad reaction” to “overdose,” and they also like the term “EpiPen” better than “fire extinguisher” for analogies describing the emergency use of naloxone to reverse effects of opioids. Researchers presented findings from their study at the recent ASHP Midyear Clinical Meeting & Exhibition in Las Vegas.

“The use of stigmatizing language in the healthcare environment is a risk to patient safety and a threat to optimal health,” said Anna Legreid Dopp, PharmD, CPHQ, ASHP senior director of clinical guidelines and quality improvement. “This study provides valuable insights about the rural communities studied and serves as a good reminder of the importance of communicating with patient-centered, nonstigmatizing language when helping patients and caregivers understand medications.”

For the study, researchers interviewed 40 rural caregivers from 4 states who had purchased naloxone at a pharmacy for someone in their household.

Language preferences for describing an opioid overdose varied somewhat by race, according to the results. Most caregivers who were White or Black favored “bad reaction.” Caregivers who were American Indian, meanwhile, preferred “accidental overdose.” All participants considered their preferred terminology to be less stigmatizing or offensive than the term “overdose.”

The study also found that 64% of rural caregivers preferred use of the term “EpiPen” in naloxone analogies. The found “EpiPen,” the brand name of an auto-injector used to deliver epinephrine for life-threatening allergic reactions, more relevant than “fire extinguisher,” a term currently suggested in some pharmacy training programs. “EpiPen” was also favored over “lifesaver,” “stick pen,” and “nasal spray.”

Although some healthcare professionals may be uncomfortable with imprecise use of “EpiPen,” employing it in an analogy is worthwhile if it avoids stigma and misunderstanding, said lead researcher Kalynn Hosea, MPH, a PharmD candidate at the University of North Carolina Eshelman School of Pharmacy in Chapel Hill.

“Familiarity with caregivers’ terminology preferences for overdose and naloxone improves the ability of healthcare professionals to provide counseling in a comprehensible and culturally sensitive manner,” she said. “Using the words that caregivers tend to favor may increase their understanding of the drug and its uses.”

 

Reference

Rural caregivers prefer 'bad reaction' to 'overdose' when explaining opioid antidote. News release. American Society of Health-System Pharmacists; November 30, 2022. Accessed December 16, 2022.

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