Salt Lake City — In an innovative project funded through the Medicare program, HealthInsight is developing a multi-faceted training program to encourage primary care providers to use a tailored, patient-centered approach to managing chronic pain for patients age 55 and older. The goals are to reduce opioid-related hospitalizations, readmissions and emergency department visits of older patients; reduce the number of older patients with risky opioid prescriptions; and increase the number of clinics that adopt a screening and referral process for opioid use disorders.
HealthInsight received this Special Innovation Project (SIP) contract in its capacity as the Medicare Quality Innovation Network-Quality Improvement Organization (QIN-QIO) for Nevada, New Mexico, Oregon and Utah. The company’s Oregon-based affiliate will conduct the SIP, working with primary care clinics in rural Oregon.
Risky prescribing (including overprescribing) of opioids to treat chronic pain is cited as a primary cause of the U.S. “opioid epidemic.” Research shows that adults over age 65 are disproportionately affected by chronic pain and are more likely to take risky medication combinations and inappropriate doses. A variety of factors, both psychological and health-based, place older adults at increased risk of opioid-related falls, hospitalizations and accidental overdoses.
Nationally, opioid-related inpatient stays for adults over age 65 jumped 85 percent between 2005 and 2014, while opioid-related emergency department visits more than doubled. In Oregon, adults age 65+ are hospitalized for opioid-related causes at a rate of 599.9 per 100,000, higher than any other state and higher than any other age group in Oregon.
In view of these factors, creating programs and best practices to reduce opioid-related harms for older adults has become a national priority―one that current opioid prescribing guidelines and initiatives have failed to address.
“We see an immediate need for training resources to guide clinical practices in screening, treating and communicating with older chronic pain patients,” said Nicole O’Kane, PharmD, clinical director with HealthInsight Oregon. “Those resources need to draw on input from patients and their family members who have direct experience with opioid therapy for chronic pain.”
HealthInsight Oregon researchers specialize in developing and evaluating prescription opioid safety initiatives and interventions targeted to health care providers. This project will develop a series of training videos and practice resources on safe opioid prescribing, screening and referral to treatment, opioid safety communication and alternative therapies, with messaging tailored for older adult patient care. The training program will be pilot tested in participating rural clinics through a dedicated website. A select group of clinics will also receive in-person technical assistance to further encourage them to implement the program’s recommended practices.
If successful, this training program could be spread nationwide through the ongoing Medicare QIN-QIO program directed by the Centers for Medicare & Medicaid Services. Projects like the Oregon SIP are aimed at expanding the scope and national impact of a quality improvement initiative that has achieved success on a more limited level, with the expectation that similar benefits would be seen on a large scale.
To learn more about this project and the benefits of participation, contact Lindsey Alley, project manager, at (503)382-3929 or LAlley@healthinsight.org.
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