Intensive intervention increases clinical adherence to opioid prescribing guidelines in chronic care

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There is much discussion on the safety and effectiveness of prescribing opioids for chronic pain patients. While the Centers for Disease Control and Prevention has issued clinical guidelines for chronic opioid therapy, these guidelines are not followed by many medical practices.

A NIDA-funded randomized controlled trial that compared two organizational strategies to improve adherence to guidelines suggests that a multi-component approach is more effective than electronic decision tools alone. The more intensive intervention included a nurse care manager, a suite of online tools, and advice and assistance from an expert in opiate prescribing (i.e., academic detailing).  While the multicomponent intervention improved adherence to the guideline-recommended monitoring of patients with chronic pain, it did not decrease early opioid refills. Further research is needed to determine whether guideline adherence reduces opioid-related risks.

For a copy of the paper — "Improving Adherence to Long-term Opioid Therapy Guidelines to Reduce Opioid Misuse in Primary CareA Cluster-Randomized Clinical Trial"— published in JAMA Internal Medicine, go to: http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2643777.

For information about opioids, go to: https://www.drugabuse.gov/drugs-abuse/opioids.

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