From Pilot Study to Culture Change: How UK HealthCare Is Reducing Opioid Prescriptions

From Pilot Study to Culture Change: How UK HealthCare Is Reducing Opioid Prescriptions



we pull the report at the state database and discover that he had doctor shopped in the span of about a month receive over a thousand pills some of them from me and that was sort of a switch moment for for me anyway the realization that all healthcare providers have played a role in this and as we're responsible for partially anyway for this opioid crisis we should take steps an action to stop it I went to my trauma group with the help of doctor Euler and other pharmacists and said we're gonna have a gentlemen and ladies agreements that we will not prescribe any opioids until we have maxed out the non-opioid options and this was an institution-wide initiative to try to examine how we're using opioids for pain management within our health care system and how that compares to what the best evidence looks like and trying to kind of close that gap so a lot of provider education some patient education guidelines protocol development some some data collection and aggregation and then presenting that and can academic detailing to various providers to try to change as appropriate or justify current practice if that's appropriate for how we're using opioids for pain management so what that roughly translates to is about a quarter of a million pills annually that we're not using that we were in in the years before we also reduce the number of opioid naive patients that leave with an opioid prescription so they didn't come in on one but they leave with one we reduce that by about two thirds and all of this was done at the same time that we saw our average pain scores our metric for how well we're controlling pain stayed the same or actually got a little bit better so we're able to use substantially less of high-risk medications without compromising or perhaps even improving pain control so beyond the ambulatory space we have the unique opportunity to train the next set of care providers again going back to setting the new norm and setting the new expectation and beyond that we can also educate our community in the bluegrass as a whole I think we're the leading academic center in our state and we're a major caretaker for this population so so we have to take a leadership role in this in this area and certainly there are a number of others outside of just this office that are doing a lot of a lot of great work with substance use disorder treatment with infectious disease screening and treatment and prevention naloxone access and community education so there's a lot of other work that's going on but within our healthcare system yeah we really needed to take a role as kind of a leader here and and saw our potential kind of foothold as that academic center for Eastern Kentucky as a real opportunity to do that

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