Credentials of Corresponding Author
PhD, RN, NEA-BC, ANEF, FAAN
Name of Faculty Advisor
Fran Vlasses
Purpose
The purpose of the project is to implement an EHR smart set that follows the newly created chronic opioid policy to decrease overall opioid prescribing, decrease prescriptions greater than 90 morphine milligram equivalent (MME) and decrease opioid and benzodiazepines prescribed simultaneously in a family medicine department.
Background and significance
The opioid crisis in the United States has become abundantly clear and many initiatives have already begun to counteract its effects on society. Over 19.1 million opioid prescriptions were written each month from 2012 to 2017. 1 in 5 adults received an opioid prescription in the last year and nearly 33% received an opioid prescription in the last two years. Loyola does not currently have an opioid protocol in the ambulatory setting. This would be the first opioid policy within the family medicine department.
Theoretical/Conceptual framework
RE-AIM (Reach, Efficacy/Effectiveness, Adoption, Implementation, Maintenance)
Method
The design of the project includes gathering longitudinal data from a cohort group (non-cancer chronic pain patients and family medicine providers). As stated prior, chronic pain patients are defined as receiving an opioid prescription for three months or greater. Comparisons will be made before and after implementation of the new opioid policy entitled “Chronic Opioid Policy”. Current practice lacks use of neither opioid policy nor an EHR smart set.
Results
Pre-implementation opioid prescribing rate was 3.25% and decreased to 2.4% during post implementation. Pre-implementation opioids over 90 MME was 0.10% rate and decreased to 0.08% during post implementation. Finally, pre-implementation opioid and benzodiazepines prescribed concurrently occurred at a 0.23% rate and decreased to 0.20% rate during post implementation.
Conclusions
The newly created opioid policy and EHR smart set appears to have a positive influence and reduction on overall opioid prescribed, opioids over 90 MME and opioids prescribed concurrently with benzodiazepines.
Guidelines for the care of chronic opioid users with the help of a clinical decision support (CDS) Tool