Reducing the Pain Behind Opioid Prescribing in Primary Care

Area of Science:

• Internal Medicine
• Pain Management
• Public Health

Background:

• Opioid prescribing in resident clinics requires effective strategies for reduction.
• Long-term opioid therapy (LTOT) management presents unique challenges in primary care settings.

Purpose of the Study:

• To evaluate the efficacy of a multifaceted intervention designed to decrease opioid prescribing within an internal medicine resident clinic.
• To assess the impact of the initiative on prescription volume, patient numbers, and morphine milligram equivalents (MMEs).

Main Methods:

• Retrospective observational study analyzing pharmacy dispensing data from July 2016 to July 2018.
• Implementation of interventions including resident education, specialized faculty supervision for LTOT, and promotion of alternative pain management modalities.
• Calculation of changes in opioid prescriptions, patient recipients, total MMEs, and average per-patient daily MMEs.

Main Results:

• Observed an average monthly reduction of 2.44% in opioid prescriptions and 1.83% in patients receiving them.
• Achieved a 74.3% reduction in total MMEs and a 66.5% reduction in average per-patient daily MMEs over two years.
• Demonstrated a nearly threefold decrease in opioid prescribing compared to national trends.

Conclusions:

• A comprehensive initiative effectively reduced opioid prescribing in a primary care resident clinic.
• The findings provide valuable insights for other academic medical centers aiming to improve opioid prescribing safety.
• The study highlights the potential for significant reductions in high-dose opioid prescribing through targeted interventions.