University of Washington-Group Health Research Team Michael Parchman, MD, MPH Director, MacColl Center for Innovation Group Health Research Institute.

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Presentation transcript:

University of Washington-Group Health Research Team Michael Parchman, MD, MPH Director, MacColl Center for Innovation Group Health Research Institute Laura-Mae Baldwin, MD, MPH Professor, Department of Family Medicine University of Washington Brooke Ike, MPH Project Manager and Practice Facilitator University of Washington David Tauben, MD Chief of Pain Medicine University of Washington

Clinic Collaborators

Key Components of the Team Based Opioid Management Approach

Support for the Project

Quality Improvement AND Research

Funded by AHRQ Grant # 1R18HS

IN WASHINGTON STATE, THERE ARE 77 OPIOIDS OR PRESCRIPTION PAIN MEDICATIONS WRITTEN FOR EVERY 100 PEOPLE.

18

Guidance recommending increased caution in COT 2010 Multi-faceted COT risk mitigation initiative Trescott, Beck, Seelig & Von Korff Health Affairs, 2011 Group Health Actions Regarding Opioids Prescribing

20 Percent of COT patients receiving > 120 mg. morphine dose GH group practice physicians Community physicians (GH contracted network)

Learning from Effective Ambulatory Practices PRIMARY CARE TEAMS:

Registry Element Suggested Frequency Type of Data Patient demographics: age, sex, marital state, race/ethnicity BaselineCategorical and Numeric Medication, Dose and frequencyEvery visitNumeric Med review for concurrent use of sedatives Every visitCategorical (yes/no) Random Urine Drug Screen All new patients; prn per policy Categorical (positive: yes/no) PEG Scale (Function and Pain)Every visitNumeric State Prescription Registry CheckEvery 6 monthsCategorical (yes/no) Prescription Opioid Misuse Index (POMI) survey Every 6 monthsNumeric PHQ-2Every 6 monthsNumeric