The opioid epidemic is growing and complex in its causes. As a health system, we know that excessive use of prescription opioids can lead to long term dependence and that unused prescription opioids are subject to abuse and diversion — fueling a dangerous epidemic of overdose and death.
“Our providers take their role as a trusted source of health care in our community very seriously,” says Barry Meisenberg, MD, chair for quality improvement and health care systems research at AAMC. “They take ownership of their role in educating patients about the dangers of opioids, and prescribing the right amount of medication.”
After a six-month research study, Dr. Meisenberg assembled AAMC’s Opioid Taskforce in January of 2017. AAMC’s goal is to reduce opioid prescribing by 50 percent by 2019. This goal is a reflection of the success the taskforce has already seen in three key clinical areas they’ve been focused on: orthopedics/sports medicine, the emergency room and our employed primary care providers.
Through provider and patient education, standardization in prescription guidelines, and engaging patients in open discussion of pain management plans, AAMC has seen a 25 percent reduction in the rate of patient visits resulting in an opioid prescription and a 40 percent reduction in overall opioid prescribing in these three areas. There has been no reduction in patient satisfaction with pain management.
Jeffrey Gelfand, MD, medical director of Orthopedic Services at AAMC, led a pilot program involving providers and surgery patients of AAMG Orthopedics and Sports Medicine Specialists.
“We came to a group consensus as to what we thought was the correct amount of narcotic needed for a given procedure. We all agreed as providers to prescribe that amount,” explains Dr. Gelfand. “We’ve been tracking our results and in the first eight months we’ve reduced our narcotic prescription by over 50 percent. We’ve done it at the same time without compromising patient comfort.”
Patients have appreciated the dialogue and have been actively engaged. AAMC is encouraged by this success and will be expanding this work to other areas of the health system.
“Our task force has concentrated on improving prescribing information and moving toward standardization and reduction. But we can’t do this alone,” says Dr. Meisenberg. “It will take great partnerships with government officials, our justice system, hospitals, providers and treatment centers to ultimately curb this epidemic.”