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Study protocol for evaluating Six Building Blocks for opioid management implementation in primary care practices.

Sarah J Shoemaker-Hunt1, Leigh Evans1, Holly Swan1

  • 1Division of Health and Environment, Abt Associates, Inc., Cambridge, USA.

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|September 5, 2020
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Summary

This study assessed the implementation of the Six Building Blocks (6BBs) program for improving opioid management in primary care. Findings inform strategies for reducing opioid prescribing and guiding practices on 6BBs implementation.

Keywords:
Chronic pain managementEvaluation designOpioid managementPractice redesignPrescribing practicesPrimary careQuality improvement

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Area of Science:

  • Implementation Science
  • Primary Care Research
  • Opioid Stewardship

Background:

  • Chronic pain patients on long-term opioid therapy require improved management strategies.
  • The Six Building Blocks (6BBs) program offers a structured approach to enhance opioid management in primary care.
  • An implementation guide was developed to facilitate independent adoption of the 6BBs program.

Purpose of the Study:

  • To evaluate the utilization of the 6BBs implementation guide by primary care practices.
  • To assess the effectiveness of the 6BBs program on opioid management processes of care.
  • To understand barriers and facilitators influencing the implementation of the 6BBs program.

Main Methods:

  • A mixed-method study guided by the Consolidated Framework for Implementation Research and CDC opioid guidelines.
  • Qualitative data from interviews, check-in calls, and document reviews explored implementation dynamics.
  • Quantitative data included provider surveys, milestone assessments, and opioid prescribing quality measures.

Main Results:

  • The study analyzed practices' motivation, history, barriers, and facilitators related to opioid management.
  • Changes in provider prescribing practices, self-efficacy, and adherence to guidelines were assessed.
  • Opioid prescribing quality measures were tracked to evaluate practice-level impact.

Conclusions:

  • The study provides insights into the implementation and effectiveness of a team-based opioid management approach.
  • Findings can inform initiatives aimed at reducing opioid prescribing.
  • Primary care practices considering the 6BBs program can utilize this information for successful implementation.