Once effective interventions have been identified, AHRQ projects and grants develop and test tools and strategies to implement what works for practice improvement and patient safety.
Clinical Decision Support
CDS Connect demonstrates how evidence-based care can be more rapidly incorporated into clinical practice through interoperable decision support. CDS Connect has built several of its projects around helping patients, clinicians, and health systems respond to the opioids crisis.
- The Pain Dashboard gives providers a "dashboard" of relevant medical record data and decision support to guide individualized chronic pain management.
- Opioids and Pain Management artifacts facilitate integration of recommendations from the CDC 2016 Opioid Prescribing Guidelines directly into an EHR.
Patient Centered Clinical Decision Support (PCCDS)
PCCDS is CDS that supports individual patients and their approved care givers and/or care teams in health-related decisions and actions by leveraging information from PCOR findings and/or patient-specific information. The PCCDS has released a Stakeholder-driven Action Plan (PDF) for Improving Pain Management, Opioid Use, and Opioid Use Disorder Treatment Through Patient-Centered Clinical Decision Support. Highlights of the report include:
- 19 PCCDS tools that support patient care for pain, opioids, and opioid use disorder (OUD).
- 5 Future Scenarios that illustrate the uses of PCCDS for pain management and opioids.
- 11 stakeholder groups and recommended actions for them to improve care through PCCDS.
- 4 areas in which PCCDS implementation efforts are already underway.
A Team-Based Approach to Improving Opioid Management in Primary Care
Six Building Blocks is a structured systems-based approach for improving management of patients on chronic opioid therapy. The Six Building Blocks program provides an evidence-based quality improvement roadmap to help primary care teams implement effective, guideline-driven care for their chronic pain and long-term opioid therapy patients. Learn more from this Q&A with AHRQ grantee Michael Parchman: Six Building Blocks help small rural clinics to manage opioids better.
Integrating Behavioral Health and Primary Care
The Academy for Integrating Behavioral Health and Primary Care Opioid & Substance Use Resources has developed several resources for providers treating opioid use disorder in primary care practices, including:
- Implementing Medication-Assisted Treatment for Opioid Use Disorder in Rural Primary Care includes an Environmental Scan (PDF, 609 KB) and an online searchable Tools and Resources Collection to support those in primary care settings who are implementing medication-assisted treatment (MAT) for opioid use disorder.
- The MAT for OUD Playbook serves as a comprehensive guide for implementing MAT in primary care and other ambulatory care settings. This interactive, web-based Playbook contains the latest guidance, tools, and resources that address all aspects of implementation. Key features include:
- A 58-item self-assessment that can be used to track progress and customize a program’s approach
- Links to more than 100 resources that will facilitate implementation of MAT for OUD
- Guidance on the North Star, a reflection of an ideal MAT program integrated into an ambulatory care setting.
- What not to do and other obstacles to avoid, in order to help programs successfully implement MAT
- The Academy Community that serves as a forum for playbook users to ask questions, offer insight, and share resources
- The ability to save notes and bookmarks to record progress, thoughts, and to-do’s for future reference
- The Academy’s Expert Insight page includes articles, blog posts, success stories, videos, and webcasts about managing Opioid Use Disorder in Primary Care.
- Increasing Access to MAT in Rural Primary Care Practices is a cooperative grant program provides access to MAT to more than 20,000 individuals struggling with opioid addiction using innovative technology, including patient-controlled smart phone apps and remote training and expert consultation using Project ECHO—a telehealth program started with AHRQ support that links specialists at an academic hub to primary care providers working on the frontlines in rural communities.
Misuse in Older Adults in Primary Care Practices
In September 2019, AHRQ launched a 3-year pilot project to assess and describe current perceptions of the challenges associated with managing opioid use and misuse in older adults; to create a compendium of tools, strategies and approaches for managing opioid use and misuse in older adults in primary care settings; to support primary care practices in developing and testing innovative strategies, approaches or tools for opioid management within the context of a facilitated Learning Collaborative; and to identify remaining evidence gaps and areas of needed research. Products and results will be posted to this website as they become available.
Making Naloxone Available in Communities
Protect.org is a grantee-developed resource designed for people seeking to learn about or obtain naloxone in their community, and for community based organizations and leaders to improve awareness of and access to naloxone for their communities. The site provides:
- Patients and their families and friends with factual, commercially unbiased information on how to obtain and use naloxone.
- Community-based organizations with freely downloadable materials, resources, and tools for raising awareness and making naloxone more available.
AHRQ-funded studies on opioids that appear in academic journals are summarized on the AHRQ Research Studies page.