Assessing Chronic Opioid Management at an Internal Medicine-Pediatrics Clinic

The number of deaths attributed to synthetic opioids has nearly tripled in the US from 1999 to 2014. Although there is limited evidence regarding the effectiveness of long-term opioid therapy for chronic pain, a condition estimated to affect 11.2% of the US adult population; opioids are often prescribed for this reason in the outpatient setting. The CDC has produced guidelines regarding safe opioid prescribing methods, however changes are also necessary within clinic systems to improve the safety and management of opioid prescriptions This is particularly important in resident led clinics where multiple providers often see patients over the course of their care. Our quality improvement (QI) project aimed to standardize clinic workflow and management of chronic opioid prescription by implementing routine surveillance screening and creating a new patient survey. Providers were also encouraged to do the following: 1) update problem lists, 2) document specific surveillance dates and signed agreements, and 3) utilize a pre-made progress note template to address specific concerns with chronic opioid use