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IT dashboard reduces high dose opioid prescriptions among veterans

TORONTO — Researchers at the Desert Pacific Veteran Integrated Service Network of Veterans Affairs have developed an IT dashboard to monitor and manage the number of Veterans treated with high-dose opioids in an effort to reduce their dose and risk for accidental or intentional overdose.

“Between 2001 and 2009, pain reliever prescriptions for U.S. military personnel has quadrupled to 3.8 million prescriptions,” Peter Hauser, MD, of the VA Long Beach Healthcare System, said during a presentation.

In 2008, 11% of armed service members reported misusing prescription drugs, Hauser said, with opioids seeing a 5- to 6-fold increase since 2002. What’s more, in 2009 one-third of suicides among army personnel involved prescription drugs.

With this in mind, in 2013 the Desert Pacific Veteran Integrated Service Network (VISN 22) developed the VISN22 High Risk for Suicide Opioid Dashboard to mediate and moderate prescription opioid rates in U.S. veterans. The dashboard calculates daily morphine equivalent daily doses (MEDD) and allows providers to assess risk factors for overdose, including major depression, PTSD, substance use disorders and Veterans already flagged to be at high risk for suicide. In addition, opioid prescribers receive a concise summary of patient medications, and can make adjustments to decrease the risk for overdose on an individual basis.

Using the dashboard, Hauser and colleagues aimed to reduce veterans’ MEDD > 200 mg — as well as those > 120 mg — to 3%. As an adjunct to the dashboard, VISN22 used academic detailing – a program in which clinicians are educated on evidence-based pharmacotherapy options.

According to Hauser, the combined strategy resulted in a 51% decrease in high-dose (MEDD > 200 mg) opioid prescriptions among veterans between January 2013 and March 2015. In addition, MED > 120 mg opioid prescriptions were reduced by 14% during this time period. Additionally, Hauser reported a 35% decrease in the number of veterans receiving prescription opioids between January 2013 and March 2015.

“This dashboard technology has assisted health care providers in prescribing opioids safely using a technology that allows for monitoring and management of concomitant accidental or intentional overdose risk factors,” Hauser said.

However, he mentioned that academic detailing and the Veteran’s Health Administration’s national Opioid Safety Initiative – which began in October 2013 – may have contributed to the success of the program. – by Stacey L. Adams

Disclosure: Hauser reports no relevant financial disclosures.

Reference:

Hauser P. The VISN22 High Risk for Suicide Opioid Dashboard: An information technology solution to monitor suicide risk in veterans prescribed high-dose opioid medications. Presented at: The APA Annual Meeting; May 16-21, 2015; Toronto.