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.
Intent to Publish Funding Opportunity Announcement for the Management of Opioids and Opioid Use Disorder in Older Adults
AHRQ intends to publish a Request for Applications (RFA) to improve the management of opioids and opioid use disorder in older adults. AHRQ’s research has shown that hospitalizations and emergency department visits related to opioids are rapidly increasing among older adults. It is known that older adults may be uniquely at risk to adverse outcomes due to polypharmacy, comorbidities, other age-related conditions, and social stigma and expectations. However, there is relatively little guidance to help clinicians and health systems optimize outcomes related to pain, function, and substance use in this population. Applicants will be expected to develop a comprehensive model that uses evidence-based interventions and quality improvement strategies designed to improve the management of pain, opioid use, and opioid use disorder for older adults in primary care.
For more information, visit https://grants.nih.gov/grants/guide/notice-files/NOT-HS-20-001.html.
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
Comments Wanted on Draft Reports on Opioids and Chronic Pain
AHRQ's Evidence-based Practice Center has posted three draft systematic reviews related to opioids and chronic pain for comment on the Effective Healthcare website.
- Noninvasive Nonpharmacological Treatments for Chronic Pain: An Update is available for review and feedback until November 12.
- Opioid Treatments for Chronic Pain is available for your review and feedback until November 12.
- Nonopioid Pharmacologic Treatments for Chronic Pain is available for review and feedback until November 12.
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.
Disparities in Opioid-related Mortality Between United States Counties From 2000 to 2014
The Journal of Drug and Alcohol Dependence published an article by AHRQ staff, Disparities in opioid related mortality between United States counties from 2000 to 2014, comparing opioid related mortality in counties across the US between 2000 to 2014. Among the findings:
- Opioid-related mortality is growing faster in counties with low initial mortality.
- County opioid mortality rates have converged to become more equally distributed.
- More counties are experiencing opioid deaths as the opioid crisis progresses.
Opioid Action Plan Final Report
The AHRQ-supported Patient-Centered Clinical Decision Support Learning Network has released its final report: A Stakeholder-driven Action Plan for Improving Pain Management, Opioid Use, and Opioid Use Disorder Treatment Through Patient-Centered Clinical Decision Support. Highlights of the report, developed by the Opioid Action Plan Working Group, include:
- 19 patient-centered clinical decision support tools that support patient care for pain, opioids, and opioid use disorder.
- 5 future scenarios that illustrate the uses of patient-centered clinical decision support for pain management and opioids.
- 11 stakeholder groups and recommended actions for them to improve care through patient-centered clinical decision support.
- 4 areas in which patient-centered clinical decision support implementation efforts are underway.
Recent Statistical Reports
Statistics from the 2016 National Inpatient Sample on inpatient stays involving mental and substance use disorders at community hospitals among patients aged 5 years or older.
Statistics on opioid-related hospitalizations among women aged 15 years and older using the 2016 National Inpatient Sample (NIS).
AHRQ’s blog posts, infographics, and announcements on its latest efforts to help end the opioid epidemic.