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By Lauren VanDenBoom

March 2, 2020

Imagine moving to a new city and calling clinic after clinic to find a new primary care physician yet being turned away. They all say, “we can’t help you,” because of treatment prescribed for a chronic condition that must be monitored on a regular basis.

A recent survey study published online by the Journal of the American Medical Association discovered that 41 percent of the primary care clinics surveyed would not accept new patients who were prescribed opioid therapy for chronic pain.1 These results are likely no surprise to the 32 million Americans prescribed chronic opioid therapy.

Why would primary care providers turn away patients? The study suggests rules and guidelines that call for monitoring and reducing opioid prescribing is the culprit. In fact, in April 2019, the Centers for Disease Control and Prevention (CDC) cautioned against misapplication in its Guideline for Prescribing Opioids for Chronic Pain. The CDC advised against abrupt tapering or sudden discontinuation of opioids. 2 Sudden discontinuation of opioids or use of non-prescribed or illicit opioids is a likely occurrence if a patient is unable to obtain appropriate care from a healthcare provider.

In its advice, the CDC asks providers to:

  • Use non-opioid treatment when possible.
  • Empathetically review risks associated with continuing high-dose opioids.
  • Collaborate with patients who agree to taper their dose.
  • If tapering, taper slowly enough to minimize withdrawal symptoms.
  • Individualize the pace of tapering.

Closely monitor and mitigate overdose risk for patients who continue to take high-dose opioids.2

Patient monitoring plays a critical role in caring for patients prescribed opioids and is included in a majority of state and federal rules and guidelines. Through monitoring, providers can identify early signs of misuse and offer intervention before serious problems like addiction and overdose can occur.

Many providers, however, see monitoring as an undue burden. Monitoring can add time and complexity to the patient visit. The provider must visit the state’s prescription drug monitoring program (PDMP) website and download a report. Then they must retrieve the laboratory’s report and compare the results. What did the patient receive from the pharmacy? Did the patient take those drugs? Did the patient take drugs that were not prescribed or were prescribed by another provider? The comparison takes time and training to interpret both reports.

What if a provider could download a single report showing an at-a-glance comparison of the patient’s PDMP result to their lab test result? If one of the most time-consuming tasks associated with monitoring chronic opioid patients was reduced to just a few mouse clicks, would more healthcare providers willingly open their doors to “opioid refugees”? Would patients be regularly monitored and receive improved care? Would opioid abuse occur less often?

We think so. That’s why hc1 created hc1 Opioid Advisor™. Through the power of the hc1 Platform™ and a partnership with APPRISS® Health, Opioid Advisor provides a clear PDMP to lab result comparison in just a few clicks. Providers can identify misuse and complete a critical patient monitoring step within moments. Visit hc1.com to learn more and request a demo.

 

References

  1. Lagisetty PA, Healy N, Garpestad C, Jannausch M, Tipirneni R, Bohnert ASB. (12 July 2019). Access to Primary Care Clinics for Patients With Chronic Pain Receiving Opioids. JAMA Netw Open. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2737896
  2. (24 Apr 2019). CDC Advises Against Misapplication of the Guideline for Prescribing Opioids for Chronic Pain. U.S. HHS. https://www.cdc.gov/media/releases/2019/s0424-advises-misapplication-guideline-prescribing-opioids.html
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