The study of the team, published in Jama Network Opennoted that a complete “de -implementation” strategy, making less of something that has proven harmful or ineffective – allowed doctors to work in clinics to reduce the levels of dosing of opioids and increase the Patients screening for pain intensity and limits to daily activities due to pain.
The opioid crisis has reached the Wisconsin particularly harshly, the state undergoing a significant increase in deaths linked to opioids in the past decade. According to experts, a large part of this impact has been motivated by an illicit use of opioids.
Between 2014 and 2019, deaths by overdose of opioids in Wisconsin increased by 46%, according to the Dashboard of the Wisconsin Department of Health Services. The trend continued to increase, data showing a persistent increase in deaths linked to opioids until 2022.
Although most deaths by opioid overdoses are caused by illegally obtained drugs, initial exposure can occur by a prescription for opioid pain drugs, the need to prescribe appropriately is essential, according to Andrew Quanbeck, Associate professor of family medicine and community health at the school of medical and public health at the University of Wisconsin, who managed the research team.
Quanbeck, who has a doctorate in industrial engineering and systems and specializes in health systems engineering, stressed the importance of care centered on the patient reflecting the updates in 2022 of the centers for disease control and prevention (CDC) which recommends reducing the prescription of opioids.
CDC guidelines on the prescription of opioids indicate that providers should prescribe smaller quantities of opioids and be slow to start new opioid prescriptions.
Over the past decade, primary care stakeholders have identified the prescription of opioids for chronic pain as among the most difficult implementation challenges they face, which can lead to conflicts with patients And for professional exhaustion, according to Quanbeck.
“The health systems have responded with opioid prescription policies to support the safer prescription of opioids, but the field of implementation science has shown several times that policies are not implementing” , he said. “We need solid and effective implementation strategies to promote the change of practice.”
The research of Quanbeck and his team reveal a possible path to reduce the prescription of opioids in primary care environments.
The study tested various methods of training health care providers on means of helping to manage chronic pain for 8,978 patients in 56 clinics while addressing the risks and advantages of opioids and compliance with guidelines for guidelines CDC opioid prescription.
The association of CDC guidelines with testing strategies of the trial in primary care establishments could lead to reducing dependence on opioid drugs for chronic pain management, he said. In fact, the team’s method has resulted in a 6% decrease in the daily dose of opioids, highlighting a small but statistically significant means of reducing the amount of prescribed opioids.
“The CDC 2022 directive to start with a low dose and go slowly with new prescriptions seems to be the strongest recommendation, based on what we have seen in the most intensive group of this study,” said Quanbeck.
Although the results are promising, Quanbeck has recognized that helping people effectively manage chronic pain is a problem that needs more work.
The de-to work study offers a roadmap for primary care providers seeking to reduce opioid prescriptions and for researchers who are trying to discover new ways to manage chronic pain, said Quanbeck .
Patients should know that when their care occurs in health systems that adopt the approach, they can expect more information on alternatives to opioids for chronic pain; Lower and short -term opioid dosage strategies; And a greater concentration on the evaluation of pain, function and quality of life with less emphasis on potentially stigmatizing opioid treatment agreements and urinary drug tests, he said.
“A de-implementation strategy means doing less about something that has proven to be harmful or ineffective, and the opioid crisis has precipitated one of the greatest de-implementation efforts ever seen in the American health care system “Said Quanbeck.