A study, published in JAMA Internal Medicine, detailed a new team-based model that lowered prescription opioid use among patients with chronic pain by almost half.
The primary care model, called TOPCARE (Transforming Opioid Prescribing in Primary Care), involves allowing nurse care managers to discuss treatment plans with chronic pain patients and to ensure monitoring occurs. The model also includes providing drug prescribers online resources and coordinating a customized educational session for primary care providers conducted by an opioid prescribing expert.
For the study, researchers examined data for nearly 1,000 chronic pain patients who received opioids through four primary care practices. Half of the primary care providers were involved in the TOPCARE model and the other half received only electronic decision support tools.
The study shows that patients whose providers participated in the TOPCARE model were prescribed lower doses of opioids and had a 40 percent greater likelihood of having their opioid medications discontinued compared to the control group.
TOPCARE patients were six times more likely to receive care that followed American Academy of Pain Medicine opioid monitoring guidelines.