Reducing opioid use for chronic pain in older adults

Autor:	Robert Roca, J. Ken Walters, Joshana Goga, Antonio DePaolo, Anita Poloway, Matthew Kopp, Annie Michaels, Marc H. Zisselman, Sunil Khushalani
Rok vydání:	2019
Předmět:	Male medicine.medical_specialty Nonpharmacologic interventions Psychological intervention Osteoarthritis Drug Prescriptions 03 medical and health sciences 0302 clinical medicine Back pain Humans Pain Management Medicine 030212 general & internal medicine Practice Patterns Physicians' Aged Aged 80 and over Patient Care Team Psychiatry Pharmacology Evidence-Based Medicine Maryland business.industry Health Policy Opioid use Age Factors Health Plan Implementation Chronic pain Opioid-Related Disorders medicine.disease Disease control Analgesics Opioid Opioid Geriatrics Practice Guidelines as Topic Critical Pathways Physical therapy Female Guideline Adherence Chronic Pain medicine.symptom business 030217 neurology & neurosurgery Program Evaluation medicine.drug
Zdroj:	American Journal of Health-System Pharmacy. 76:554-559
ISSN:	1535-2900 1079-2082
DOI:	10.1093/ajhp/zxz025
Popis:	Purpose Implementation of the SAFE PAIN algorithm for reducing opioid use for chronic pain in older adults is described. Summary A multidisciplinary team at Sheppard Pratt Health System, the largest private provider of psychiatric care in Maryland, used lean methodology to identify the root causes for noncompliance to evidence-based practices for patients in the geropsychiatry unit treated for osteoarthritis or chronic back pain. The team collaborated to develop a facility-specific treatment algorithm, called SAFE PAIN (Sheppard Pratt Health System Algorithm For Elderly Patient Centered Analgesia Interdisciplinary Nagara), was based on the Center for Disease Control and Prevention’s evidence-based recommendations that included nonpharmacologic interventions as a first-line therapy for patients with osteoarthritis or chronic back pain. Rates of prescribing new opioids and prescribing evidence-based alternative medications via the SAFE PAIN algorithm were evaluated from March 1 to September 30, 2017 and compared with baseline (2012–2016). The lean methodology interventions led to zero new opioid orders during the study period, a significant decrease compared with previous years (p < 0.01). The rates of prescribing evidence-based alternative medications increased significantly from the baseline period to postimplementation (p < 0.01). Lean methodology interventions also decreased waste in several processes. Conclusion The prescribing rate of new opioids for osteoarthritis and chronic back pain decreased and the prescribing rate for evidence-based medications increased after implementation of the SAFE PAIN algorithm in a geropsychiatry unit.
Databáze:	OpenAIRE
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