Examining the Effect of a Whole Health Primary Care Pain Education and Opioid Monitoring Program on Implementation of VA/DoD-Recommended Guidelines for Long-term Opioid Therapy in a Primary Care Chronic Pain Population

• Published in: Pain medicine (Malden, Mass.) Vol. 21; no. 10; pp. 2146 - 2153
• Main Authors: Marszalek, Deanna, Martinson, Amber, Smith, Andrew, Marchand, William, Sweeney, Caroline, Carney, Julie, Lowery, Tiffany, Clinton-Lont, Jamie
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.10.2020
• Subjects: Adult; Analgesics, Opioid - therapeutic use; Between-subjects design; Chronic pain; Chronic Pain - drug therapy; Drug screening; Drug therapy; Drug utilization; Evaluation; Humans; Methods; Morphine; Naloxone; Narcotics; Opioids; Pain; Patient education; Practice guidelines (Medicine); Prescription Drug Monitoring Programs; Prescription drugs; Primary care; Primary Health Care; Therapeutic drug monitoring; Veterans; United States; Opioid Monitoring Program; Opioid Therapy; Primary Care; Chronic Pain
• ISSN: 1526-2375; 1526-4637; 1526-4637
• DOI: 10.1093/pm/pnaa155

To describe the core elements of a Whole Health Primary Care Pain Education and Opioid Monitoring Program (PC-POP) and examine its effectiveness at increasing adherence to six of the Veteran Affairs/Department of Defense (VA/DoD) recommended guidelines for long-term opioid therapy (LOT) among chronic noncancer patients seen in primary care (i.e., urine drug screens [UDS], prescription drug monitoring program [PDMP] queries, informed consent, naloxone education/prescriptions, morphine equivalent daily dose [MEDD], and referrals to nonpharmacological pain interventions). A within-subjects comparison of outcomes was conducted between pre- and post-PC-POP enrollees (N = 25), as was a a between-subjects comparison to a comparison group (N = 25) utilizing a six-month range post-index date of 10/1/2018 (i.e., between-subjects comparison at Time 2). A convenience sample of adult veterans with chronic noncancer pain receiving opioid therapy consecutively for the past three months in primary care. Results showed increased concordance with VA/DoD guidelines among those enrolled in the PC-POP, characterized by increased documentation of urine drug screens, prescription drug monitoring program queries, informed consent, naloxone education/prescriptions, and a decrease in MEDD among patients enrolled in the PC-POP. The PC-POP shows promise for increasing guideline-concordant care for providers working in primary care.