It Takes A Village to Curb the Prescription Opioid Epidemic: Supply healthcare providers with resources to improve patient safety

Transcription

1 Session L6 This presenter has nothing to disclose It Takes A Village to Curb the Prescription Opioid Epidemic: CDC Efforts Jan Losby, PhD Team Lead, Overdose Prevention Health Systems Team Division of Unintentional Injury Prevention Centers for Disease Control and Prevention December 4, :00-4:30 28thIHIFORUM Pillars of CDC s Overdose Prevention Work Supply healthcare providers with resources to improve patient safety P2 Strengthen state efforts by scaling up effective public health interventions Improve data quality and track trends 1

2 CDC Guideline for Prescribing Opioids for Chronic Pain P3 Patients 18 years or older with chronic pain Outpatient settings Outside of active cancer, palliative, and end of life care Primary care providers Organization of Guideline Recommendations P4 12 recommendations are grouped into three conceptual areas: Determining when to initiate or continue opioids for chronic pain Opioid selection, dosage, duration, follow-up, and discontinuation Assessing risk and addressing harms of opioid use 2

3 Dissemination & Implementation Approach P5 Translation & Communication Clinician Education & Training Health Systems Interventions Insurer Interventions Translation & Communication P6 Checklist Tapering Nonopioid Treatments Pharmacists on the Front Lines Assessing Benefits and Harms of Opioid Therapy Prescription Drug Monitoring Programs (PDMPs) Calculating Total Daily Dose of Opioids for Safer Prescribing 3

4 Provider Materials P7 4

5 Patient Materials Graphics and messages Fact Sheets Prescription Opioids: What You Need to Know Pregnancy and Opioids Posters Podcasts Infographics P9 Clinician Education & Training P10 5

6 Clinician Outreach and Communication Activity (COCA) Webinars P11 Earn CMEs/CEs: 1. Overview of Guideline 2. Nonopioid Treatments for Chronic Pain 3. Assessing Benefits and Harms of Opioid Therapy 4. Dosing and Titration of Opioids 5. Opioid Use Disorder Assessment and Referral 6. 12/6: Risk Mitigation Strategies 7. 12/13: Effective Communication with Patients /index.asp Coming Soon P12 Mobile app with morphine milligram equivalent (MME) calculator Videos Brochures and pocket guides Online training for providers 6

7 Training Resources: Online Course P13 elearning Web-based training Modules that can be completed in 30 minutes or less Learner-directed content Scenario-based interactions Mini-lessons on implementing the guideline Short videos Health Systems Interventions P14 7

8 P15 Quality Improvement (QI) Initiative Create QI measures Create QI implementation guide Launch & support Opioid QI Collaborative in 6 health care systems Clinical Decision Supports CDC & ONC collaborating Create sharable EHR code/artifacts Clinical sites to implement guideline & track outcomes P16 Coordinated Care Plan Created the Chronic Pain Care Involving Opioids: A Coordinated Care Plan for Safer Practice Informed by Group Health and VA Rigorous evaluation underway at MedStar in Maryland (9 clinical intervention sites & 9 clinical comparison sites) Broad dissemination following evaluation conclusion 8

9 Insurer Interventions P17 Coverage for non-pharmacologic therapies Improve ease of prescribing non-opioid pain medications Reimbursement for patient counseling, care coordination, & checking PDMP Promote more judicious use of high dosages of opioids outside of palliative care, active cancer or end-of-life care, using mechanisms such as drug utilization review Remove barriers to evidence-based treatment of opioid use disorder, such as eliminate lifetime limits on buprenorphine CDC Funded States P18 Funded State Unfunded State Five Components PDMPs System-Level Evaluate Policy Surveillance Rapid Response 9

10 Guideline Dissemination & Implementation: P19 State Examples Translation & Communication Disseminating Materials to stakeholders Clinician Education & Training Academic Detailing Health Systems EHR & PDMP (Prescription Drug Monitoring Program) Integration Insurers Workers Compensation Medicaid U.S. Health and Human Services Secretary s Opioid Initiative P20 Focus on three priority areas that tackle the opioid crisis and significantly impact those struggling with substance use disorders to help save lives 1 Providing training and educational resources to assist health professionals in making informed prescribing decisions 2 Increasing use of Naloxone 3 Expanding the use of Medication-Assisted Treatment 10

11 Resources & Contact Information P21 CDC Opioid Overdose Prevention Website: HHS Prescription Drug & Heroin Overdose Epidemic: Turn the Tide (Surgeon General s website): Presenter Contact Information: Jan Losby JLosby@cdc.gov Disclaimer: The findings and conclusions of this presentation are those of the presenter and do not necessarily represent the official position of the Centers for Disease Control and Prevention. 11