HIGHLIGHTS
- Doctors lacked consensus on prescribing opioids, with wide geographic variations.
- Abt helped devise an opioid prescribing guideline.
- Abt is developing quality improvement interventions for the prescribing guideline.
The Challenge
Nearly 50,000 persons died of opioid overdoses in 2017, which contributed to the first-ever decline in working-age Americans’ life expectancy. A 2012 Abt Global study found wide geographic variation in opioid prescribing in the United States, indicating a lack of consensus among doctors in how to manage non-cancer pain outside of palliative and end-of-life care.
The Approach
To remedy this, the Centers for Disease Control and Prevention (CDC) undertook several efforts to provide health care providers with evidence-based guidance. CDC contracted with Abt to provide research support, including conducting literature reviews, synthesizing research, assembling evidence tables, and providing editorial support for draft clinical recommendations. In March 2016, the CDC issued the CDC Guideline for Prescribing Opioids for Chronic Pain.
The Results
Because guidelines are not self-executing, the CDC’s National Center for Injury Prevention and Control contracted with Abt for three related projects. The first was to develop and pilot a coordinated care plan for opioid prescribing: CDC Quality Improvement and Care Coordination. Another is to develop quality improvement (QI) measures for opioid therapy in outpatient primary care settings and to support a QI collaborative with a dozen large healthcare systems. Finally, Abt is developing clinical decision support tools and implementing them in four pilot healthcare systems’ electronic health records to assist physicians in following best practices and the CDC’s guideline recommendations.
Abt is a maintenance of certification provider through the American Board of Medical Specialties. We offer this service as part of our quality improvement work only to clinicians participating in the project.
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