Reframing Optimal Management of Pain and Opioids in Older Adults

项目总结。

Project Summary. The prevalence of self-reported pain among older adults has increased 2-3 percent annually in recent decades. Safely prescribing opioids or alternatives for geriatric pain requires consideration of polypharmacy, cognitive and physical function, caregivers, social supportive services, and end-of-life preferences. Practice improvement efforts have rarely been directed at primary care (PC) practices with a large proportion of geriatric patients, so most older adults do not receive a proper risk assessment, including for opioid use disorder (OUD). The proposed project, Managing Pain Safely in Older Adults, is a partnership between the University of Michigan (UM) and Altarum, bringing extensive expertise in implementing pain management practice improvements through multi-faceted approaches using evidence- based prescriber education, academic detailing, ongoing feedback, practice management and prescriber support, as well as leveraging electronic health record (EHR) technology. The UM and Altarum are in the third year of a partnership leading a Health and Human Services, Office of Minority Health-funded program to prevent and reduce opioid-related morbidity and mortality (Detroit Opioid Prevention Collaborative), using intervention strategies like those we propose for this project. Our Managing Pain Safely in Older Adults project combines Altarum’s expertise in engaging hundreds of PC practices in quality improvement and provider and patient education programs, along with their nationally recognized expertise in eldercare, with UM’s expertise implementing evidence-based pain management and prevention and treatment of OUD—specifically screening, opioid tapers, and provision of medication assisted treatment (MAT). In alignment with AHRQ’s mission, we aspire to implement, study, and disseminate methods by which to provide safer and more equitable pain management care to older adults.