Page 16 - Christiana Care Focus October 2018

Ed Ewen, M.D.
Acute Medicine | Opioidguidelines CONTINUED
“We can find those patients and focus on them with a concerted team effort to mitigate their risk.”
Ed Ewen, M.D.
“We can find those patients and focus on them with a concerted team effort to mitigate their risk,” Dr. Ewen said.
Another key focus, Dr. Kerzner said, is to try alternative approaches for patients who started using opioids in the past few months and whose use may become chronic.
There is some evidence that a team approach focusing on high-risk populations can pay off.
A pilot project at the Rocco A. Abessinio Family Wilmington Health Center at Wilmington Hospital resulted in a 37 percent reduction in the number of patients on chronic opioid therapy.
A PILOT PROJECT SAW A
37% REDUCTION IN THE NUMBER OF PATIENTS on chronic opioid therapy for primary care patients.
Delaware OPEN tackles acute pain
Many patients are first exposed to opioids after a surgical proce- Bdure, and too many of them eventually become dependent on them.
uilding on the work by a grant-funded effort in Michigan called the Opioid Prescribing Engagement Network, or OPEN, Christiana Care developed a straightforward set of guidelines that recommend specific medications and
quantities after 21 surgical procedures.
Led by anesthesiologist Matt Powell, M.D., Delaware OPEN intends to reduce the wide variation in the number and type of opioids
prescribed after surgeries. Patients who are prescribed more opioids than they need sometimes hold on to them and use them later for ailments like pain, depression or trouble sleeping, he said.
Often, prescribing fewer opioids means accepting some level of pain after a procedure. Dr. Powell says doctors are now talking about pain in terms of function: Can the patient work, sleep and carry out other everyday tasks?
Though the guidelines are optional for prescribers, the early data showing a 40 percent reduction in opioids — which relates to 14 types of surgical procedures performed from July 2017 to July 2018 — shows many are taking the new advice.
On Aug. 15, Christiana Care hosted a team from Michigan who shared their results to a statewide audience that included other Delaware health systems.
14 CHRISTIANA CARE HEALTH SYSTEM