Adherence to opioid prescribing guidelines at an academic family medicine practice
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View abstract on PubMed
Summary
This summary is machine-generated.Compliance with CDC opioid guidelines remained low despite interventions. Residents showed higher adherence, while tramadol use was linked to lower urine drug screen rates, indicating a need for ongoing education.
Area Of Science
- Internal Medicine
- Primary Care
- Clinical Quality Improvement
Background
- The United States Centers for Disease Control and Prevention (CDC) provides guidelines for opioid prescribing, yet clinical practice data is limited.
- A primary care residency site implemented a quality improvement initiative in 2022 to enhance adherence to CDC opioid best practices.
- This initiative involved policy changes and educational interventions for both clinicians and patients.
Purpose Of The Study
- To analyze the clinical impact of a quality improvement initiative aimed at increasing compliance with CDC opioid prescribing guidelines.
- To evaluate the rates of opioid agreements and urine drug screens (UDS) among patients on chronic opioid therapy.
Main Methods
- A retrospective chart review of 245 patients on chronic opioids during 2023 was conducted.
- Data extracted included prescriber type, opioid details, benzodiazepine co-prescription, and mental health diagnoses.
- Key outcomes measured were the presence of an opioid agreement and a urine drug screen (UDS) within the past 12 months.
Main Results
- Forty-one percent of patients had a UDS in 2023; predictors included non-tramadol opioid use and an opioid agreement.
- Thirty-two percent had a completed opioid agreement; predictors included mental health diagnoses, provider type, and UDS completion.
- Twenty-nine percent of patients were prescribed benzodiazepines, and 69% had a mental health diagnosis.
Conclusions
- Despite policy and education, compliance with key outcomes (opioid agreements, UDS) remained low.
- Residents demonstrated the highest compliance rates.
- Lower UDS compliance was noted with tramadol prescriptions, highlighting areas for targeted educational efforts and future quality improvement.
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