Safer and more appropriate opioid prescribing: a large healthcare system's comprehensive approach

摘要: Rationale, aims, and objectives The United States is in the midst of a public health epidemic with more than 40 people dying each day from prescription opioid overdoses. Health care systems are taking steps to address overdose by implementing policy practice interventions mitigate risks long-term therapy. Kaiser Permanente Southern California launched comprehensive initiative transform way that chronic pain viewed treated. created prescribing dispensing policies, monitoring follow-up processes, clinical coordination through electronic record integration. The purpose this paper describe implementation these assess impact set on prescribing. Method The study used retrospective pre-post evaluation design track outcomes before after intervention. members age 18 older excluding cancer, hospice, palliative patients sub-population 3 203 880 was approximately 75% all members. All data Permanente's pharmacy collected rolling basis as were implemented January 2010 December 2015. Results There reductions tracked outcomes: 30% reduction opioids at high doses; 98% number prescriptions quantities greater 200 pills; 90% decrease combination an benzodiazepines carisoprodol; 72% Long Acting/Extended Release opioids; 95% brand name opioid-acetaminophen products. In addition, methadone did not increase during period. Conclusions This adds promising results system-level strategy has ability positively affect prescribing. basic components intervention generalizable applicable other settings.