A toolkit to implement opioid quality improvement efforts in primary care: Findings from a mixed-methods study.

Objective: The Six Building Blocks: A Team-Based Approach to Improving Opioid Management in Primary Care (6BBs) program provides a roadmap for improving the management of patients on opioid therapy for chronic pain. The goal of this project was to evaluate the How-to-Implement Toolkit (Toolkit) for clinics to independently implement the 6BBs without a practice facilitator.

Methods: Eight healthcare organizations with 62 clinics participated in the program.

Implementation of a Quality Improvement Learning Collaborative to Support Implementation of the 2016 CDC Guideline for Prescribing Opioids for Chronic Pain: Case Study from Nurse-Led Clinics.

Purpose: The authors describe a case study of a quality improvement initiative to implement the 2016 CDC Guideline for Prescribing Opioids for Chronic Pain ("2016 CDC Guideline") into nurse-led primary care practices in central Appalachia.

Design: In this controlled pre-post quality improvement study, a policy change, an electronic health record form, and supporting education were implemented. Knowledge change and quality improvement metrics were measured before and after implementation.

Factors That Affect Opioid Quality Improvement Initiatives in Primary Care: Insights from Ten Health Systems.

Objective: To improve patient safety and pain management, the Centers for Disease Control and Prevention (CDC) released the Guideline for Prescribing Opioids for Chronic Pain (CDC Guideline). Recognizing that issuing a guideline alone is insufficient for transforming practice, CDC supported an Opioid Quality Improvement (QI) Collaborative, consisting of 10 health care systems that represented more than 120 practices across the United States. The research team identified factors related to implementation success using domains described by the integrated Promoting Action on Research Implementation in Health Services (iPARIHS) implementation science framework.

Study protocol for evaluating Six Building Blocks for opioid management implementation in primary care practices.

Background: The Six Building Blocks for improving opioid management (6BBs) is a program for improving the management of patients in primary care practices who are on long-term opioid therapy for chronic pain. The 6BBs include building leadership and consensus; aligning policies, patient agreements, and workflows; tracking and monitoring patient care; conducting planned, patient-centered visits; tailoring care for complex patients; and measuring success. The Agency for Healthcare Research and Quality funded the development of a 6BBs implementation guide: a step-by-step approach for independently implementing the 6BBs in a practice.

The Effect of Opioid Stewardship Interventions on Key Outcomes: A Systematic Review.

Objectives: We sought to identify potential patient safety practices to reduce high-risk opioid prescribing.

Methods: We conducted a systematic review of the literature to identify opioid stewardship (OS) strategies implemented in primary care and other settings. Included studies evaluated an OS strategy or a multicomponent OS initiative to address potential harms of opioids and used experimental or quasi-experimental designs.

Using Deprescribing Practices and the Screening Tool of Older Persons' Potentially Inappropriate Prescriptions Criteria to Reduce Harm and Preventable Adverse Drug Events in Older Adults.

Objectives: Approximately 98% of older Americans are simultaneously taking 5-or more-medications to manage at least 2 chronic conditions. Polypharmacy and the use of potentially inappropriate medications (PIMs) are a concern for older adults because they pose a risk for adverse drug events (ADEs), which are associated with emergency department visits and hospitalizations and are an important patient safety priority. We sought to review the evidence of patient safety practices aimed at reducing preventable ADEs in older adults, specifically (i) deprescribing interventions to reduce polypharmacy and (ii) use of the Screening Tool of Older Persons' Potentially Inappropriate Prescriptions (STOPP) to reduce PIMs.

Development, Testing and Results of a Patient Medication Experience Documentation Tool for Use in Comprehensive Medication Management Services.

The medication experience is an individual's subjective experience of taking a medication in daily life and can be at the root of drug therapy problems. It is recommended that the patient-centered approach to comprehensive medication management (CMM) starts with an understanding of the patient's medication experience. This study aims to develop a medication experience documentation tool for use in CMM services, and to understand the usefulness and challenges of using the tool in practice.