Reframing Optimal Management of Pain and Opioids in Older Adults

重新制定老年人疼痛和阿片类药物的最佳管理

• 批准号: 10463630
• 负责人: Daniel William Berland
• 金额: $ 69.18万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-01 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10463630
• 关键词: Reframing; Optimal; Management; Pain; Opioids

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.

项目摘要。 老年人自我报告疼痛的患病率每年增加2- 3% 近几十年来。安全处方阿片类药物或替代药物治疗老年疼痛需要 多药治疗的考虑，认知和身体功能，照顾者，社会支持 服务和临终偏好。实践改进工作很少直接 在初级保健（PC）的做法与老年患者的比例很大，所以大多数老年人 成年人没有接受适当的风险评估，包括阿片类药物使用障碍（OUD）。的 拟议的项目，管理疼痛安全的老年人，是一个伙伴关系， 密歇根大学（UM）和Altarum，带来了广泛的专业知识，在实施疼痛 通过多方面的方法利用证据改进管理实践， 基于处方者的教育，学术细节，持续反馈，实践管理 和处方支持，以及利用电子健康记录（EHR）技术。的 UM和Altarum是在第三年的合作伙伴关系，领导一个健康和人类服务， 少数民族健康办公室资助的预防和减少阿片类药物相关发病率的计划， 死亡率（底特律阿片类药物预防协作），使用干预策略，如我们 建议这个项目。我们的老年人安全管理疼痛项目结合了 Altarum的专业知识，在从事数百个PC的做法，在质量改进和 提供者和患者教育计划，沿着他们的国家认可的专业知识， 老年人护理，利用UM的专业知识实施循证疼痛管理， 预防和治疗OUD-特异性筛查，阿片类药物逐渐减少，并提供 药物辅助治疗（MAT）。根据AHRQ的使命，我们希望 实施、研究和传播各种方法，以提供更安全、更公平的 老年人的疼痛管理