Krebs CDA

Improving the Quality and Safety of Opioid Prescribing in Primary Care
Principal Investigator: Erin E. Krebs, MD, MPH
Project Number CD207215-2
Funded by VA Health Services Research & Development

BACKGROUND
Use of opioid analgesics for chronic pain has increased dramatically in the past two decades, with much of the increase occurring in primary care. Challenges to providing high quality opioid management in primary care are numerous. Although many aspects of opioid pain management remain controversial, consensus exists on the need for structured therapeutic monitoring to ensure the effectiveness and safety of opioid treatment for individual patients. Consistent with other national guidelines, joint clinical practice guidelines issued by the VA and Department of Defense recommend regular assessment of effectiveness, adherence, adverse effects, and evidence of misuse, abuse, addiction, or diversion for patients treated with long-term opioids for chronic pain.

The overall research objective is to develop a model primary care-based program to improve the quality and safety of opioid management for veterans with chronic pain.
Specific aims:
1. Identify opportunities for improvement in current opioid management processes.
2. Assess patients’ and primary care providers’ attitudes, beliefs, and preferences regarding opioid monitoring strategies.
3. Identify barriers and facilitators to implementing primary care-based interventions to promote safe and effective opioid use for veterans with chronic pain.
4. Develop and pilot test a primary care-based opioid management improvement program.