Feasibility of Novel Opioid Assessment Tool for Rehabilitation Patients in a Skilled Nursing Facility

A uniform standardized assessment of opioid treatment does not exist to guide management decisions for patients in skilled nursing facilities (SNFs). The purpose of this study is to determine if (1) a novel opioid assessment tool can be feasibly used to support clinician decision-making in opioid management for patients in rehabilitation, and (2) if this tool can address the existing gaps in care to pain management in SNFs.

This qualitative study thematically analyzed anonymous interview responses from SNF providers.

SNF providers and nursing staff from SNFs in 1 hospital system participated in structured interviews.

The Pain Assessment and Documentation Tool, validated to evaluate opioid therapy and its impact on function over time in the outpatient setting, was modified to assess opioid treatment in SNFs. SNF providers were invited to participate in anonymous interviews regarding the tool's use and feasibility. Interview transcripts were analyzed using NVivo data analysis software to generate themes to determine the most significant takeaways.

Twenty providers were interviewed and found that the tool was feasible for use in SNFs to improve clinical decision-making. Assessing patient's activities of daily living and opioid misuse risk were the most positively regarded metrics of the tool. The tool was found to provide standardization and specificity for management decisions, address the current gap in standardization and communication between providers, and improve existing variability in treatment of patients with substance use disorder and cognitive impairment. The barriers to implementation include that the tool is too redundant and can contribute to worsening staff burden.

This study found that this novel tool of opioid management is feasible in SNFs, and that it standardizes opioid management, improves provider communication, and reduces variability in treating patients with substance use disorder.