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Mixed methods formative evaluation of a collaborative care program to decrease risky opioid prescribing and increase

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Summary
This summary is machine-generated.

This study found high organizational readiness for the Primary Care-Integrated Pain Support (PIPS) program. Identifying system and patient barriers, alongside the crucial role of clinical pharmacists, can improve opioid regimen reduction.

Keywords:
Chronic painFormative evaluationImplementation scienceMixed-methodsOpioid

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Area of Science:

  • Health Services Research
  • Implementation Science
  • Pain Management

Background:

  • Rising opioid prescribing and associated harms necessitate effective interventions.
  • Significant barriers hinder the reduction of risky opioid regimens.
  • Non-pharmacologic pain management modalities require increased uptake.

Purpose of the Study:

  • To identify barriers and facilitators for implementing the Primary Care-Integrated Pain Support (PIPS) program.
  • To evaluate organizational readiness for implementing PIPS within the VA.
  • To support the reduction of risky opioid regimens and increase non-pharmacologic treatment.

Main Methods:

  • Mixed-methods formative evaluation across three VA sites.
  • Quantitative survey using the Organizational Readiness for Implementing Change (ORIC) scale (n=18).
  • Qualitative semi-structured phone interviews with a subset of participants (n=9).

Main Results:

  • High organizational readiness for PIPS implementation indicated by ORIC scores.
  • Identified system-level barriers (provider tension) and patient-level barriers (perceived support).
  • Clinical pharmacist role emerged as a key facilitating factor for PIPS.

Conclusions:

  • High organizational readiness suggests feasibility of PIPS implementation.
  • Strategic modifications, such as utilizing clinical pharmacists as champions, can enhance implementation.
  • Marketing PIPS to leadership can improve VA opioid safety metrics and implementation capacity.