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A Systematic Approach to Opioid Prescribing.

Kelly Bossenbroek Fedoriw1, Amy Prentice1, Sue Slatkoff1

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|November 21, 2020
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Summary

Implementing an opioid stewardship program significantly reduced opioid prescribing rates by 31% and concurrent benzodiazepine-opioid use by 56%, enhancing patient safety in family medicine.

Keywords:
Addictive BehaviorBenzodiazepinesChronic DiseaseChronic PainFamily MedicineOpioid-Related DisordersOpioidsPatient SafetyPrimary Health Care

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Area of Science:

  • Family Medicine
  • Public Health
  • Pharmacology

Background:

  • Opioid misuse represents a critical national health crisis.
  • Medical practices require improved standards for opioid prescribing.
  • Academic family medicine centers can lead in developing solutions.

Purpose of the Study:

  • To develop, implement, and evaluate opioid stewardship initiatives.
  • To ensure appropriate opioid prescribing practices.
  • To support clinicians in providing optimal patient care.

Main Methods:

  • A practice-wide opioid prescribing policy was established.
  • A controlled medication advisory board (CMAB) was created.
  • Clinician feedback, training, and electronic health record data were utilized for evaluation.

Main Results:

  • Opioid prescribing rates decreased by 31% between 2014 and 2018.
  • Concomitant use of benzodiazepines and opioids decreased by 56%.
  • The CMAB reviewed 117 referrals, with 60% leading to treatment plan revisions.

Conclusions:

  • Standardized, evidence-based protocols are crucial for safe opioid prescribing.
  • Provider and patient support enhances the effectiveness of stewardship programs.
  • These initiatives improve patient safety and the quality of care.