Developing a Health Services Research Agenda To Combat the Opioid Crisis
As the Nation faces an unprecedented opioid epidemic, we are faced with numerous unanswered questions about potential strategies to attack the problem:
- Could community pharmacists dispense daily methadone to people with opioid use disorder?
- How can emergency departments most effectively connect people to medication-assisted treatment in the community after treatment for an overdose?
- Can mobile apps connect people in rural communities to culturally responsive behavioral health support as part of addiction recovery?
- What are the unintended consequences of restrictions in the supply of prescription opioids, and how can we safeguard against unintended harms?
- What financing systems incentivize efficient, effective, and accessible multispecialty pain management clinics?
Stepping back, we may ask: are these the highest priority questions that health services researchers can answer to assist the Nation in addressing our opioid and pain epidemics? The only way to determine how health services research (HSR) can help is if we work together as a field to set the agenda.
In February 2018, a blog post by AHRQ Director Gopal Khanna described Agency efforts to fight the opioid epidemic, including publication of a collection of 250 tools for implementing medication-assisted treatment in primary care, as well as a report on noninvasive, non-drug treatment of chronic pain.
In addition, the Agency has released new data on emergency department visits related to opioid use and hospitalizations for opioids by payer. Meanwhile, AHRQ is developing electronic clinical decision support tools, building a public Web portal for primary care practices, and conducting evidence reviews on substance abuse treatment for adolescents and screening for substance abuse in primary care.
Our next step is to start a conversation with researchers and the users of research at the AcademyHealth 2018 Annual Research Meeting. I will be chairing a session on Tuesday, June 26, at 10 a.m. ET to address how a 360-degree, whole-person approach to HSR can help reverse the national epidemic. My colleague Pam Owens, Ph.D., who has been instrumental in the development of AHRQ's data tools, will join me at this session, as will Michael Parchman, M.D., M.P.H., of the Kaiser Permanente Washington Health Research Institute, to discuss his AHRQ-supported project on improving opioid management in primary care.
Their presentations will offer case examples of how research efforts are already making a difference in the health care system. But because we understand there is much more work to be done, this session will also start a conversation on what path our future work should take. As I prepare for the session, I have thought of a few questions to start the discussion and frame a research agenda:
- What is the role of HSR in combatting the opioid crisis?
- What are the most pressing questions facing health care delivery systems—and what questions might arise in 5 years?
- Are there novel methods and/or research designs well suited for this area?
The health care system played an important role in creating the opioid crisis, and I believe the health services research community must have a vital role in ending it. The solutions we create will not only address pain and opioid addiction, but also build more resilient health care organizations that are better able to deliver high-quality, safe, accessible, equitable care to future generations of Americans.
I hope you can join us tomorrow at the session. If not, we still want to know your thoughts and ideas. Please email them to firstname.lastname@example.org.
Dr. Meyers is Chief Medical Officer of AHRQ.
Page originally created June 2018