Safe Opioid Prescribing in Primary Care Through Implementation of Evidence-Based Guidelines

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Starnes, M. (2021). Safe Opioid Prescribing in Primary Care Through Implementation of Evidence-Based Guidelines. Unc Charlotte Electronic Theses And Dissertations.
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Abstract

Many people are affected by chronic pain. The use of opioids for pain has resulted in an increase in the number of opioid-related overdose deaths. The Center for Disease Control (CDC) created opioid prescribing guidelines to help providers safely prescribe opioids for chronic pain. The purpose of this project was to create an electronic medical record (EMR) template and urine drug test (UDT) alert to increase the providers’ adherence to the CDC opioid guidelines in a small, hospital-owned, family practice clinic. A pre/post implementation chart review tool was used to evaluate the medical records of 60 patients prescribed chronic opioids. The tool was used to determine if providers were adhering to the guidelines. Measures included the number of patients who completed an annual UDT, signed a controlled substance agreement (CSA), documented pain diagnosis, quarterly office visits, and if providers reviewed the prescription drug monitoring program (PDMP) every 3 months. Adherence improved in the post-implementation data compared to pre-implementation. There were statistically significant increases in CSA (p<.001), PDMP reviewed (p=.000), annual UDT (p=.005), and quarterly appointments (p=.006). Although not statistically significant, there was an increase in documented pain diagnosis (p=.492). Implementation of an EMR template and UDT alert led to an increase in provider adherence to opioid prescribing guidelines.

Details
Author

Starnes, Michelle

Title

Safe Opioid Prescribing in Primary Care Through Implementation of Evidence-Based Guidelines

Physical Description

1 online resource (37 pages) : PDF

Date

2021

Degree Granting Institution

University of North Carolina at Charlotte

Abstract

Many people are affected by chronic pain. The use of opioids for pain has resulted in an increase in the number of opioid-related overdose deaths. The Center for Disease Control (CDC) created opioid prescribing guidelines to help providers safely prescribe opioids for chronic pain. The purpose of this project was to create an electronic medical record (EMR) template and urine drug test (UDT) alert to increase the providers’ adherence to the CDC opioid guidelines in a small, hospital-owned, family practice clinic. A pre/post implementation chart review tool was used to evaluate the medical records of 60 patients prescribed chronic opioids. The tool was used to determine if providers were adhering to the guidelines. Measures included the number of patients who completed an annual UDT, signed a controlled substance agreement (CSA), documented pain diagnosis, quarterly office visits, and if providers reviewed the prescription drug monitoring program (PDMP) every 3 months. Adherence improved in the post-implementation data compared to pre-implementation. There were statistically significant increases in CSA (p<.001), PDMP reviewed (p=.000), annual UDT (p=.005), and quarterly appointments (p=.006). Although not statistically significant, there was an increase in documented pain diagnosis (p=.492). Implementation of an EMR template and UDT alert led to an increase in provider adherence to opioid prescribing guidelines.

Genre

doctoral dissertations

Subjects--Topics

Nursing

Degree

D.N.P.

Keywords

Chronic Opioid Therapy
Chronic
Non-Cancer Pain
EMR Template
Opioid Guidelines
Pain Management
Provider Adherence

Subject Area

Health Services Research

Advisor(s)

Burfield, Allison

Committee Members

Troutman-Jordan, Meredith
Sigmon-Laws, Lynne
Turner, Michael

Degree Note

Thesis (D.N.P.)--University of North Carolina at Charlotte, 2021.

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Rights Holder Information

Copyright is held by the author unless otherwise indicated.

Identifier

Starnes_uncc_0694D_12716

Permalink

http://hdl.handle.net/20.500.13093/etd:2024