A Quality Improvement Project for Improving Controlled Substance Prescribing in a Primary Care Setting
Background: Implementations of guidelines for opioid management can reduce the related harms of addiction, overdose and death. However, implementation in clinical settings has been historically challenging. A Needs Assessment to help inform the development of an educational training for prescribers and incorporate other initiatives to improve the uptake of evidence-based guidelines in a primary care setting was conducted.
Process: This was a Quality Improvement projected conducted at Henry J Austin Health Center (HJAHC) in Trenton, New Jersey. The needs assessment consisted of a chart review and semi-structured interviews. The chart reviewed calculated the rate of Prescription Drug Monitoring Data Base (PDMP) checks. Semi-structured phone interviews took place with 1 MD and 7 Nurse Practitioners. A thematic analysis was used to analyze the interviews.
Results: The rate of PDMP checks was calculated to be three checks per ten encounters. Three themes emerged from the semi-structured interviews. The themes were: Organizational challenges in prescribing controlled substances, Organizational barriers to accessing the PDMP, and Feelings of not being on the same page/unified.
Discussion and Conclusions: All the prescribers expressed that they believed that the PDMP is an excellent website, but time and technological factors are barriers. Additionally, prescribers expressed the want for educational training and support, particularly those that can bring them closer as a team. The next steps currently being taken include working with the IT team to integrate the PDMP into the prescribers' EMR and working with the QI team to create educational training.
Zelman, PharmD, Theresa, "A Quality Improvement Project for Improving Controlled Substance Prescribing in a Primary Care Setting" (2021). Master of Public Health Capstone Presentations. Presentation 369.
Poster attached as supplemental file below