The 2022 Center for Disease Control and Prevention (CDC) clinical practice guideline for prescribing opioids for pain recommends that when tapering a patient's opioid dose, doses should be decreased at a slow rate to reduce the risk of withdrawal symptoms, overdose, and to promote tolerance of the tapering. This project will examine the state of tapering in primary care across the system as well as conduct stakeholder interviews to understand the resources available across the system to support providers in tapering and identify opportunities for clinical decision support to be implemented to support guideline concordant tapering. Utilization of a clinical care pathway that gives providers information, recommendations, and educational material on strategies for opioid tapering will be examined. The rate of opioid tapering in line with CDC guidelines will be examined as well as long term patient outcomes of opioid overdose of poisoning using existing patient health records. The study period will be approximately 8 months.
Have an active opioid prescription for more than 3 months and
Prescribed more than 90 morphine milligram equivalents (MME) per day or
Co-prescribed an opioid and benzodiazepine or
Received a reduction in opioid dosage by more than 5% MME per day
Patients <12 and >89
Patients with active cancer diagnosis in last 1 year
Patients with hospice care/palliative care order
Patients with sickle cell disease diagnosis
Residents and visitors to the state of Colorado who seek healthcare within the University of Colorado Health (UCHealth) primary care system receiving long-term opioid treatment.
Cohort
Retrospective
Observational study without a prospective intervention
Other interventionobservational study without a prospective intervention
Percentage of potential taper-benefit patients
The percentage of chronic opioid primary care patients for which EHR risk indicates tapering may be beneficial
Observed tapering
The percentage of primary care patients with sustained opioid morphine milligram equivalence (MME) rates declining monthly as an indication of tapering
Taper magnitude
The percentage of primary care patients with sustained opioid morphine milligram equivalence (MME) rates declining monthly at a rate in line with guideline recommendations
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University of Colorado, Denver
Lead sponsor
National Institute on Drug Abuse (NIDA)
Collaborator
National Institutes of Health (NIH)
Collaborator
This trial is not recruiting at the moment. You can still explore other options:
