From 2006 to 2012, 76 billion
oxycodone and hydrocodone pills were distributed throughout the US. That’s an
average of nearly 11 billion pain pills per year. Additionally, a report from
the Centers for Disease Control and Prevention found that only one
overdose-reversal drug was dispensed for every 69 high-dose opioid
prescriptions.
Clinicians can play a significant role in
addressing the opioid epidemic that takes the lives of tens of thousands of
people every year.
Evaluate Existing Prescribing
Practices
One study shows that around six percent of
patients who undergo (minor or major) surgery will experience persistent opioid
use after 90 days. This is especially problematic when some providers are
writing prescriptions for more than 100 pain pills. Between 2011 and 2016
alone, thousands of
surgeons across the US wrote prescriptions after surgeries for dozens of opioid
pills—far above most post-surgical guidelines.
While there are certainly factors like
complications or automated prescribing programs that default to preset amounts,
surgeons can have a significant impact on the opioid crisis by reviewing their
organization’s prescribing habits as well as their own.
How Technology Can Provide
Life-Saving Information
Over 20 percent of
US adults live with chronic pain. Additionally, pain has been cited as the top reason
patients access the American healthcare system. That means all physicians and
clinicians with prescribing power can positively affect the opioid crisis by
taking more care when prescribing medications for pain management. However,
many providers, particularly those in emergency medicine, don’t know when a
patient has gotten opioids from previous emergency department (ED) visits or
primary care physicians due to lack of insight into patient medical and
prescription histories.
To address this problem, Alaska created
statewide initiatives that included prescribing guidelines, public and
physician education, and a prescription drug monitoring program (PDMP). This
has helped many hospitals throughout the state gain insight into patient
patterns and better track prescription opioid misuse.
At Mat-Su Regional Medical Center in Alaska,
one woman with major medical problems visited the ED with complaints of severe
pain. Physicians didn’t realize she was already receiving opioids from her
primary care provider, and the woman chose not to disclose it. This meant
well-meaning physicians could have been justified in issuing another
prescription, fueling a problem with substance use disorder, which could then
result in overdose or even death.
Mat-Su had implemented Collective’s platform
and integrated it with the state’s PDMP. Through this technology, physicians
gained real-time information on a patient’s visit and prescription history,
helping them make informed decisions. This visibility allowed Mat-Su physicians
to see the above woman’s prescribing history and provide the care she really
needed.
“With Collective, rather than making
judgements about patients, we have actual data to reference,” says Anne Zink,
MD, FACEP, and Emergency Medicine Director at Mat-Su. “This makes it a lot
easier to have a conversation with the patient, starting with ‘Let’s see what
you’re facing, what the underlying problem is, and why you’re really bouncing
between providers.’”
Mat-Su has been able to keep patient
satisfaction high while reducing the number of opioid prescriptions written by
nearly 80 percent
through local efforts, statewide initiatives, PDMP integration, and care
collaboration fueled by technology.
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