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    Four health systems develop opioid mitigation programs


    Cedars-Sinai Medical Center

    Cedars-Sinai, a hospital and multi-specialty academic health science center in Los Angeles, is also exploring effective ways for doctors to discuss opioid use with patients suffering from chronic pain. A $2 million grant from the Patient-Centered Outcomes Research Institute is funding the research, which will begin this year. The study will review prescription claims data, include patient feedback, and capture pain medication use through EHRs.

    Similar to the UC Davis research findings, Brennan Spiegel, director, health services research for Cedars-Sinai, says patients have misconceptions about their physicians and expectations for treatment of their chronic pain—making them unaware of the range of side effects that might accompany opioid use and whether the drugs are appropriate.

    Physicians, addiction specialists, and primary care providers at the health system will work closely with patients over a year comparing the effectiveness of two established communication strategies used by doctors who treat chronic pain patients.

    The first technique will be physician facing. Providers will receive computerized decision support based on guidelines from Choosing Wisely, which advises against opioid treatment as first-line therapy for chronic, non-cancer pain. The guidelines are hard-wired into EHRs so that physicians will receive a reminder at the point of care and provide an alternative. In the other protocol, patients will receive educational materials through the patient/provider portal prior to an office visit. 

    Researchers plan to survey patients one month after their visits to determine quality of life; overall health, including pain and energy level; and the effectiveness of conversations with their providers.

    Mari Edlin, a frequent contributor to Managed Healthcare Executive, is based in Sonoma, California.

    Mari Edlin
    Mari Edlin is a frequent contributor to Managed Healthcare Executive. She is based in Sonoma, California.

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