Outcomes Associated With a Multidisciplinary Pain Oversight Committee to Facilitate Appropriate Management of Chronic Opioid Therapy

The lack of an assessment of both patient-centered and clinical outcomes is an additional limitation of this study. Rates of annual UDS and PDMP database reviews and the number of patients receiving high-risk COT are only surrogate metrics that may indicate appropriate prescribing and monitoring of these. Obtaining a UDS or PDMP review is meant to provide a practitioner with additional information to interpret when caring for a patient. These data are only meant to complement—not replace—skilled patient assessment by a provider. Although the authors observed no major patient or clinical adverse events during the study period, the possibility exists that a patient may have been negatively impacted by a population-level initiative to improve surrogate measures of appropriate drug use.

Future studies should assess changes in measures, such as pain scores, legitimate adverse events, and overdose occurrences in order to evaluate whether such opioid improvement initiatives truly benefit the patients who are ultimately affected by each intervention.

Conclusion

This study demonstrates the successful implementation of a VHA-based opioid management initiative to increase appropriate COT monitoring and appropriate management of high-risk patients. It is the authors’ hope that the findings may add to the growing body of literature describing successful opioid improvement initiatives and serve as a tool for other health systems that are confronted with these same issues.