Using Integrated Interventions to Increase Compliance in Opioid Prescribing

Researchers presented at the American Academy of Pain Medicine’s 36th Annual Meeting a poster titled, “Integrated Interventions to Increase Compliance with Practice Guidelines for Opioid Prescribing for Chronic, Non-Cancer-Associated Pain in an Academic Rheumatology Practice”

“There is substantial concern regarding the use of opioids in patients with chronic, noncancer-associated pain,” explained Eric Wang, MD, and colleagues. “Within the University of Pennsylvania Health System the Division of Rheumatology was the fifth-highest prescriber of opioids in 2016, by number of tablets.”

For this study, division leadership and providers established shared goals at interdisciplinary meetings involving rheumatology, pain medicine, nursing, and pharmacy. Informational sessions on opioid prescribing, new electronic health record tools, and sharing of individual prescribing patterns, were among the inventions examined.

The providers utilized an opioid dashboard that was built into the electronic health record in order to track individual and group profiles for total opioid tablets prescribed, as well as offer insight into prescribing habits—such as benzodiazepine coprescriptions. Baseline data was from June 2017 through August 2017 and was compared with monthly data through December 2018.

According to the researchers, “at baseline, 1.3% of patients had active opioid agreements, 89% had a provider visit within 3 months of the most recent opioid prescription, 25% had a urine drug screen result within 12 months of the most recent opioid prescription, and 24% had concurrent benzodiazepine prescriptions.” Sixteen months post introduction of the intervention program, these percentages were 80%, 90%, 66%, and 16%, respectively.

Opioid tablet prescription decreased 25% (54,170 vs 40,894) and provider satisfaction was recorded as high. 

“Shared goals developed through interdisciplinary input and feedback from outcomes data can markedly increase compliance with current guidelines for safe opioid prescribing for patients with chronic, non-cancer-associated pain,” concluded the researchers.  —Edan Stanley