Better monitoring for prescription painkillers
A new approach to prescription painkillers at Group Health Cooperative could become a model for other medical providers.
Painkillers have become a national concern because they're addictive and there’s been an uptick in overdoses. The number of people who have long-term prescriptions for painkillers has doubled over the past decade.
But typically, doctors haven’t been keeping close tabs on these patients after the prescription is written. Michael von Korff of Group Health Research Institute in Seattle says it can start unintentionally, for example, when someone has sudden back pain:
“So they start using a prescription pain medicine for it, and then it’s not really better so they get a refill. Then a couple more refills down the road, they are using opioids [such as Oxycontin or Vicodin] longer term, without necessarily anyone having made a decision there was going to be a transition to using these medications long term.”
Now, with so many of those pills in circulation, they’re fueling addiction and overdoses.
Group Health is getting national attention for its new approach, which was published in the August edition of Health Affairs.
There are two aspects, which could become more widespread. First, Group Health searched its database for patients who have been taking prescription opiates for 90 days or longer. Then, they setup a routine for doctors to spend time consulting with each of those patients (more than 6,000 so far) about the risks and trade-offs of taking painkillers for long periods.
Group Health says the new approach has been overwhelmingly popular, since the consultations started in October 2010. The program is partially modeled on efforts at the Veterans Administration to get a handle on opiate abuse.
When the new federal health care law, the Affordable Care Act, expands coverage in 2014, more people will have access to prescription painkillers – as well as to drug abuse treatment.