TOPCARE Intervention Can Improve Adherence to Long-Term Opioid Guidelines

September 13, 2017 | Strategic Insights for Health System


A multicomponent intervention combining individual functions known to be effective on their own improved adherence to long-term opioid guidelines, but did not reduce incidence of early refills, according to a study published in the September 2017 issue of JAMA Internal Medicine. A major driver of the opioid crisis is the presence of properly prescribed pain killers that are subsequently sold for nonmedical reasons, the authors said. The authors conducted a cluster-randomized clinical trial to see whether a multicomponent intervention known as Transforming Opioid Prescribing in Primary Care (TOPCARE)—which combined nurse care management, use of an electronic registry, individualized performance feedback, and electronic decision tools—could improve opioid prescribing practices. The study was conducted among 53 clinicians treating 985 patients receiving long-term opioid therapy for pain at one of four safety-net primary care facilities from January 2014 through March 2016.

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