Safe Opioid Prescribing in Primary Care Through Implementation of Evidence-Based Guidelines

Many people are affected by chronic pain. The use of opioids for pain has resulted in an increase in the number of opioid-related overdose deaths. The Center for Disease Control (CDC) created opioid prescribing guidelines to help providers safely prescribe opioids for chronic pain. The purpose of this project was to create an electronic medical record (EMR) template and urine drug test (UDT) alert to increase the providers’ adherence to the CDC opioid guidelines in a small, hospital-owned, family practice clinic. A pre/post implementation chart review tool was used to evaluate the medical records of 60 patients prescribed chronic opioids. The tool was used to determine if providers were adhering to the guidelines. Measures included the number of patients who completed an annual UDT, signed control substance agreement (CSA), documented pain diagnosis, quarterly office visits, and if providers reviewed the prescription drug monitoring program (PDMP) every 3 months. Adherence improved in the post-implementation data compared to pre-implementation. There were statistically significant increases in CSA (p=.000), PDMP reviewed (p=.000), annual UDT (p=.005), and quarterly appointments (p=.006). Although not statistically significant, there was an increase in documented pain diagnosis (p=.492). Implementation of an EMR template and UDT alert led to an increase in provider adherence to opioid prescribing guidelines.