Funding Announcement: Improving Management of Opioids and Opioid Use Disorder (OUD) in Older Adults (R18)
The Agency for Healthcare Research and Quality (AHRQ) seeks applications to develop, implement, evaluate, and disseminate strategies to improve the management of opioid use, misuse, and opioid use disorder (OUD) in older adults in primary care settings, especially in settings with large segments of socially at-risk older adults. The United States is in the midst of an unprecedented opioid crisis that is affecting people from all walks of life. Regulators and policymakers have initiated many activities to curb the crisis, but relatively little attention has been paid to the growing toll of opioid use, opioid misuse, and OUD in older adults. Between 2010 and 2015, the rate of opioid-related inpatient stays and emergency department (ED) visits increased for people 65 years or older by 34% and 74%, respectively. This includes older adults who experienced common side effects from opioids such as constipation, confusion, nausea, falls, etc., as well as overdoses.
Applicants must propose a comprehensive plan that uses evidence-based interventions and quality improvement strategies designed to improve the management of pain, opioid use, and OUD for older adults in primary care. For more information, please visit RFA-HS-20-001. Applications are due by February 20, 2020, by 5:00 PM local time of applicant organization.
A Technical Assistance call will be held on January 21, 2020, from 1:00-2:00 p.m. ET. To register to participate in the conference call, please send an email request to Elisabeth.Kato@ahrq.hhs.gov by January 16, 2020.
AHRQ Systematic Review Cited in the New York Times
AHRQ's systematic review on noninvasive nonpharmacological pain treatment for chronic pain was recently cited in the New York Times to support the importance of addressing mental health along with physical health.
Overprescription of Opioids Following Sinonasal Surgery
AHRQ grantees Jeremy Meier et al. found that excess opioids were prescribed 85 percent of the time to patients undergoing sinonasal surgery, while a total of 76 percent of patients incorrectly discarded/stored excess opiates. Their research "Prescription Patterns and Opioid Usage in Sinonasal Surgery" appears in the International Forum of Allergy & Rhinology on November 6, 2019.
Treatment of Acute Pain: An Evidence Map posted
The Evidence Based Practice Centers (EPC) Program posted an evidence map on the treatment of acute pain on October 22. This report maps the current evidence for several acute pain conditions including postoperative pain, dental pain, neck pain, back pain, renal colic, acute migraine, and sickle cell crisis to provide a high-level overview of the current guidelines and systematic reviews on pharmacologic and nonpharmacologic treatments for acute pain. Based on this map, the EPC program is moving forward with two systematic reviews to support CDC guidelines for treatment of a range of acute pain conditions. Draft reports will be available for comment in 2020
Persistent Opioid Use Following Ureteroscopy
AHRQ grantees John Hollingsworth et al. report that nearly one in 16 opioid-naive patients develop new persistent opioid use after URS. New persistent opioid use is associated with the amount of opioid prescribed at the time of URS. Given these findings, urologists should re-evaluate their post-URS opioid prescribing patterns. Complete findings are available at "New Persistent Opioid Use after Outpatient Ureteroscopy for Upper Tract Stone Treatment" in Urology.
MAT for OUD Playbook
To support the U.S. Department of Health and Human Services Opioid Initiative, AHRQ funded the development of a new MAT for OUD Playbook. This playbook serves as a comprehensive guide for implementing medication-assisted treatment (MAT) in primary care and other ambulatory care settings. The interactive, web-based playbook contains the latest guidance, tools, and resources that address all aspects of implementation. It adopts a holistic, patient-centered approach to care for individuals with Opioid Use Disorder (OUD) and offers a set of principles for substance use treatment integrated in ambulatory care settings. 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
Trends in the Rate of Opioid-Related Hospitalizations
This interactive data visualization presents opioid-related hospitalizations per 100,000 population from 2005-2016 using AHRQ’s Healthcare Cost and Utilization Project data. It shows national and state trends and state demographics by sex, income, patient location (rural, small metropolitan, medium metropolitan, large fringe metropolitan, and large central metropolitan), and age.
Opioid Prescribing Practices in the United States and England
JAMA Network Open published Comparison of Opioid Prescribing by Dentists in the United States and England by AHRQ grantee Katie Suda, Pharm.D, MS, et. al. The study finds that in 2016, the proportion of prescriptions written by U.S. dentists that were for opioids was 37 times greater than the proportion written by English dentists.
AHRQ’s blog posts, infographics, and announcements on its latest efforts to help end the opioid epidemic.