Improving Adherence to Opioid Prescribing CDC Guidelines for Chronic Pain

dc.contributor.advisorReed, W. Garyen
dc.contributor.committeeMemberKandil, Enasen
dc.contributor.committeeMemberPhelps, Eleanoren
dc.creatorZamir, Aemenen
dc.creator.orcid0000-0002-7001-7145 2021
dc.description.abstractBACKGROUND: The Centers for Disease Control and Prevention have released treatment guidelines for chronic pain care as concerns about opioid overuse and abuse increase. Additionally, The Texas Medical Board has outlined their policy for the use of medication for non-malignant chronic pain purposes in Rule 170.3 of the Texas Administrative Code. Some of the requirements include a signed pain management agreement, regular review of the Prescription Monitoring Program, a urine drug screen, and documentation of completion of requirements in patient's medical records. OBJECTIVE: Establish baseline adherence to TMB policy for opioid prescribing and implement electronic medical record tools to facilitate completion of requirements METHODS: A preliminary chart review of patients on the opioid registry, an intervention in early phase of implementation meant to easily identify patients receiving opioids for chronic pain, was conducted to determine baseline adherence to Rule 170.3 amongst physicians. Several CDC guidelines which corresponded with TMB requirements were chosen. Post-intervention data was collected from the chronic opioid registry regarding the percentage of patients who had annual review of Prescription Monitoring Database, a urine drug screen, a pain management agreement, and documentation of completion of requirements in patient's medical records. RESULTS: Of the 206 patients studied through chart review pre-intervention, only 6% had all three TMB mandated elements in their charts. After implementing the EMR tools meant to facilitate completion of TMB laws and CDC guidelines, the percentage of patients with a urine drug screen and review of PDMP increased while the percentage of patients with a pain management agreement in their chart decreased. CONCLUSION: Poor compliance in the UTSW system necessitates tools that will streamline the process for completing and documenting the requirements. The implementation of the EHR tools and the opioid registry best practice alerts, as they were rolled out by the Opioid Task Force, helped facilitate completion of requirements.en
dc.subjectAnalgesics, Opioiden
dc.subjectChronic Painen
dc.subjectDrug Prescriptionsen
dc.subjectMedication Adherenceen
dc.subjectPractice Guidelines as Topicen
dc.subjectPrescription Drug Misuseen
dc.titleImproving Adherence to Opioid Prescribing CDC Guidelines for Chronic Painen
dc.type.materialtexten Southwestern Medical Schoolen Improvement and Patient Safetyen Southwestern Medical Centeren with Distinctionen


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