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A Systematic Approach to Opioid Prescribing.
J Am Board Fam Med. 2020 Nov-Dec; 33(6):992-997.JA

Abstract

BACKGROUND AND OBJECTIVES

Opioid misuse has become a national crisis. In response to the need for improved standards of opioid prescribing within medical practices, a university-based academic family medicine practice developed, implemented, and evaluated a series of initiatives to ensure appropriate opioid prescribing and support clinicians in the practice in providing optimal care.

METHODS

In 2015-2018, the University of North Carolina Family Medicine Center developed and implemented a practice-wide opioid prescribing policy, created a controlled medication advisory board (CMAB), provided regular feedback to clinicians on opioid prescribing, and trained selected providers in management of opioid use disorder. The impact of these opioid stewardship initiatives on prescribing patterns, utilization of the CMAB, and provision of medications for opioid use disorder was evaluated using electronic health record data from 2015 to 2018 and chart audits.

RESULTS

Between 2014 and 2018 the opioid prescribing rate per 100 patient visits decreased by 31% and the rate of concomitant use of benzodiazepines and opioids decreased by 56%. The CMAB received 117 referrals between 2015 and 2018, 60% of which resulted in recommended revision in the treatment plan.

CONCLUSIONS

Safe opioid prescribing is essential to mitigate the opioid crisis. An evidence-based standardized protocol, coupled with support for providers and patients, can reduce prescribing and improve patient safety, thereby enhancing the comprehensiveness and quality of patient care.

Authors+Show Affiliations

From the Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC.From the Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC.From the Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC.From the Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

33219078

Citation

Bossenbroek Fedoriw, Kelly, et al. "A Systematic Approach to Opioid Prescribing." Journal of the American Board of Family Medicine : JABFM, vol. 33, no. 6, 2020, pp. 992-997.
Bossenbroek Fedoriw K, Prentice A, Slatkoff S, et al. A Systematic Approach to Opioid Prescribing. J Am Board Fam Med. 2020;33(6):992-997.
Bossenbroek Fedoriw, K., Prentice, A., Slatkoff, S., & Myerholtz, L. (2020). A Systematic Approach to Opioid Prescribing. Journal of the American Board of Family Medicine : JABFM, 33(6), 992-997. https://doi.org/10.3122/jabfm.2020.06.190463
Bossenbroek Fedoriw K, et al. A Systematic Approach to Opioid Prescribing. J Am Board Fam Med. 2020 Nov-Dec;33(6):992-997. PubMed PMID: 33219078.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A Systematic Approach to Opioid Prescribing. AU - Bossenbroek Fedoriw,Kelly, AU - Prentice,Amy, AU - Slatkoff,Sue, AU - Myerholtz,Linda, PY - 2019/12/20/received PY - 2020/05/29/revised PY - 2020/06/02/accepted PY - 2020/11/21/entrez PY - 2020/11/22/pubmed PY - 2021/8/19/medline KW - Addictive Behavior KW - Benzodiazepines KW - Chronic Disease KW - Chronic Pain KW - Family Medicine KW - Opioid-Related Disorders KW - Opioids KW - Patient Safety KW - Primary Health Care SP - 992 EP - 997 JF - Journal of the American Board of Family Medicine : JABFM JO - J Am Board Fam Med VL - 33 IS - 6 N2 - BACKGROUND AND OBJECTIVES: Opioid misuse has become a national crisis. In response to the need for improved standards of opioid prescribing within medical practices, a university-based academic family medicine practice developed, implemented, and evaluated a series of initiatives to ensure appropriate opioid prescribing and support clinicians in the practice in providing optimal care. METHODS: In 2015-2018, the University of North Carolina Family Medicine Center developed and implemented a practice-wide opioid prescribing policy, created a controlled medication advisory board (CMAB), provided regular feedback to clinicians on opioid prescribing, and trained selected providers in management of opioid use disorder. The impact of these opioid stewardship initiatives on prescribing patterns, utilization of the CMAB, and provision of medications for opioid use disorder was evaluated using electronic health record data from 2015 to 2018 and chart audits. RESULTS: Between 2014 and 2018 the opioid prescribing rate per 100 patient visits decreased by 31% and the rate of concomitant use of benzodiazepines and opioids decreased by 56%. The CMAB received 117 referrals between 2015 and 2018, 60% of which resulted in recommended revision in the treatment plan. CONCLUSIONS: Safe opioid prescribing is essential to mitigate the opioid crisis. An evidence-based standardized protocol, coupled with support for providers and patients, can reduce prescribing and improve patient safety, thereby enhancing the comprehensiveness and quality of patient care. SN - 1558-7118 UR - https://neuro.unboundmedicine.com/medline/citation/33219078/A_Systematic_Approach_to_Opioid_Prescribing_ DB - PRIME DP - Unbound Medicine ER -