Opioid safety initiative: clinical pharmacy intervention

Introduction: National concern over the rise in opioid overdose-related deaths has led the Department of Veterans Affairs (VA) to launch the Opioid Safety Initiative (OSI). This initiative involves efforts to promote safe opioid prescribing and monitoring within the VA. Objectives: This project aims to educate providers to identify and reduce the amount of patients who may be inappropriately prescribed chronic opioids, based on the analysis of providers’ responses to urine drug screen (UDS) results. In doing so, the final objective is that the Tuscaloosa Veterans Affairs Medical Center meet goals for certain core measures of the OSI. These goals include falling below the national average in the percentage of patients within the facility on 100 to <200 mg and 200 to <300 mg of morphine equivalent daily dose for a fiscal year quarter. Study Design: Retrospective, non-research, quality improvement Methods: A report of the percentage of patients on 100 to <200 mg and 200 to <300 mg of morphine equivalent daily for the fourth quarter of fiscal year 2015 (Q4FY15) was generated for use as baseline data. Subsequently, a list of patients with a positive UDS for amphetamines, marijuana, cocaine, and methadone while on chronic opioid therapy was generated for Q4FY15. Retrospective chart reviews were conducted, and the findings organized into spreadsheets for analysis of providers’ responses. Similarly, steps were taken to organize and analyze patients on chronic opioid therapy with a negative UDS for opioids. Findings from these chart reviews were communicated to providers. Education was also provided for providers to document and, if needed, take further action on UDS results, prior to making a decision regarding continuation of opioids. Following this educational intervention, data for Q2FY16 will be compared to baseline data to determine whether OSI core measure goals have been met. Results: In progress Conclusions: In progress