TY - JOUR
AU - R. J. Fortuna
AU - J. Venci
AU - W. Johnson
AU - J. S. Clark
AU - S. Schlagman
AU - K. Vandermark
AU - A. Stetzer
AU - G. S. Nasra
AU - S. G. Martin-Stancil-El
AU - S. Judge
A1 - 
AB - In response to the opioid epidemic, the Centers for Disease Control and Prevention released best practice recommendations for prescribing, yet adoption of these guidelines has been fragmented and frequently met with uncertainty by both patients and providers. This study aims to describe the development and implementation of a comprehensive approach to improving opioid stewardship in a large network of primary care providers. The authors developed a 3-tier approach to opioid management: (1) establishment and implementation of best practices for prescribing opioids, (2) development of a weaning process to decrease opioid doses when the risk outweighs benefits, and (3) support for patients when opioid use disorders were identified. Across 44 primary care practices caring for >223,000 patients, the total number of patients prescribed a chronic opioid decreased from 4848 patients in 2018 to 3106 patients in 2021, a decrease of 36% (P < 0.001). The percent of patients with a controlled substance agreement increased from 13% to 83% (P < 0.001) and the percent of patients completing an annual urine drug screen increased from 17% to 53% (P < 0.001). The number of patients coprescribed benzodiazepines decreased from 1261 patients at baseline to 834 at completion. A total of 6.5% of patients were referred for additional support from a certified alcohol and substance abuse counselor embedded within the program. Overall, the comprehensive opioid management program provided the necessary structure to support opioid prescribing and resulted in improved adherence to best practices, facilitated weaning of opioids when medically appropriate, and enhanced support for patients with opioid use disorders.
AD - Department of Internal Medicine, University of Rochester, Rochester, New York, USA.; Primary Care Network, University of Rochester, Rochester, New York, USA.; Department of Psychiatry, University of Rochester, Rochester, New York, USA.; School of Nursing, University of Rochester, Rochester, New York, USA.
AN - 38237106
BT - Popul Health Manag
C5 - Opioids & Substance Use; Healthcare Disparities
CP - 1
DA - Feb
DO - 10.1089/pop.2023.0234
DP - NLM
ET - 20240118
IS - 1
JF - Popul Health Manag
LA - eng
N2 - In response to the opioid epidemic, the Centers for Disease Control and Prevention released best practice recommendations for prescribing, yet adoption of these guidelines has been fragmented and frequently met with uncertainty by both patients and providers. This study aims to describe the development and implementation of a comprehensive approach to improving opioid stewardship in a large network of primary care providers. The authors developed a 3-tier approach to opioid management: (1) establishment and implementation of best practices for prescribing opioids, (2) development of a weaning process to decrease opioid doses when the risk outweighs benefits, and (3) support for patients when opioid use disorders were identified. Across 44 primary care practices caring for >223,000 patients, the total number of patients prescribed a chronic opioid decreased from 4848 patients in 2018 to 3106 patients in 2021, a decrease of 36% (P < 0.001). The percent of patients with a controlled substance agreement increased from 13% to 83% (P < 0.001) and the percent of patients completing an annual urine drug screen increased from 17% to 53% (P < 0.001). The number of patients coprescribed benzodiazepines decreased from 1261 patients at baseline to 834 at completion. A total of 6.5% of patients were referred for additional support from a certified alcohol and substance abuse counselor embedded within the program. Overall, the comprehensive opioid management program provided the necessary structure to support opioid prescribing and resulted in improved adherence to best practices, facilitated weaning of opioids when medically appropriate, and enhanced support for patients with opioid use disorders.
PY - 2024
SN - 1942-7891
SP - 1
EP - 7+
ST - Comprehensive Approach to Opioid Management in a Primary Care Network
T1 - Comprehensive Approach to Opioid Management in a Primary Care Network
T2 - Popul Health Manag
TI - Comprehensive Approach to Opioid Management in a Primary Care Network
U1 - Opioids & Substance Use; Healthcare Disparities
U3 - 10.1089/pop.2023.0234
VL - 27
VO - 1942-7891
Y1 - 2024
ER -