AHRQ Issues Guide for Improving Long-term Opioid Management

As the AAFP's position paper on chronic pain management and opioid misuse states, however, the medical system is not designed to effectively care for patients who have chronic pain. As a result, family physicians often find themselves trying to strike a balance between addressing their patients' chronic pain and ensuring that they are using opioids appropriately.

To help family physicians and other clinicians better manage these patients, the Agency for Healthcare Research and Quality has published a self-service how-to guide outlining steps to improve opioid management in primary care. The guide is designed to support clinics in their efforts to implement effective, guideline-driven care for patients who use long-term opioid therapy.

"Finding ways to alleviate patients' pain while ensuring the safe and appropriate use of opioids is one of the most challenging jobs facing our doctors and nurses," said AHRQ Director Gopal Khanna, M.B.A., in an AHRQ blog post announcing the guide's release. "It is my hope that this new guide helps our clinicians navigate that essential pathway as we continue to confront the national opioid crisis."

Although the guide can be useful to anyone interested in improving long-term opioid management, it is specifically intended for clinicians and their staff, quality improvement personnel, practice coaches and clinic administrators. The guide builds on the Six Building Blocks program, which helps practice teams redesign key work areas to enhance opioid management without external support.

Funded by AHRQ and created through a research collaboration among three institutions, including the University of Washington Department of Family Medicine in Seattle, the program walks stakeholders through a six-part quality improvement process that focuses on

• building leadership support and organization-wide consensus;
• developing and implementing opioid prescribing policies, patient agreements and workflows;
• tracking and monitoring patient care;
• instituting planned, patient-centered visits;
• developing specific policies and resources to manage complex patients; and
• continuously monitoring progress and measuring success.

Accordingly, the new how-to resource consists of an introduction and three corresponding guide sections:

• Prepare and Launch;
• Design and Implement; and
• Monitor and Sustain.

Each section provides a list of objectives and contains links to additional resources and example workflows for the different process steps. Overall, the guide is designed to help practices implement the Six Building Blocks program in three stages over 15 months.

It's worth noting that the CDC Guideline for Prescribing Opioids and Chronic Pain is among resources the guide links users to. The AAFP gave the agency's guideline its affirmation of value designation in 2016.

As always, AAFP members are encouraged to review the Academy's resources on this important topic, including the Chronic Pain Management Toolkit.