Report on Managing Pain

HHS https://www.hhs.gov, Department of Defense (DOD) https://www.defense.gov, Veterans Administration https://www.va.gov  (VA) and the Office of National Drug Control Policy (ONDCP) https://www.whitehouse.gov/ondcp convened the “Pain Management Best Practices Inter-Agency Task Force” to address acute and chronic pain in conjunction with the ongoing opioid crisis.

The Task Force identifies gaps, inconsistencies, provides updates and makes recommendations on how to best manage acute and chronic pain. The 29 members of the Task force includes federal agency representatives as well as non-federal experts and stakeholders

On May 6, 2019, the Task Force produced the draft final report titled “Pain Management Best Practices” to include updates, gaps, inconsistencies, and recommendations on how to best manage pain.

Section 3 in the report titled “Cross-Cutting Clinical and Policy Best Practices” includes a section on how Prescription Drug Monitoring Programs (PDMP) are faring along with gaps in the system, plus includes recommendations on how to improve and move the system forward to better address pain management.

PDMPs enable prescribers and pharmacists and in some states, insurers, researchers, and medical licensing boards to access the data, the ability to monitor use by patients, monitor prescribing practices by practitioners, and check population level drug use trends. Today, 49 states and most of Missouri and the District of Columbia have operational PDMPs.

PDMPs can support safe prescribing and dispensing practices and help curb opioid prescription by detecting patterns that can alert clinicians to patients who may be at risk of a Substance Use Disorder (SUD) and importantly, provide clinicians with lifesaving information.

PDMP use varies across the U.S with variability in PDMP design, state’s health IT infrastructure, and current regulations on prescriber registration, access, and use. Some of the recommendations and suggestions on how to modernize and enhance the functionality of PDMPs include:

  • Consider checking PDMPs with other risk stratification tools upon the initiation of opioid therapy
  • Provide clinician training on accessing and interpreting PDMP data
  • Conduct studies to better identify where PDMP data is best used such as in inpatient versus outpatient settings
  • State EHRs should integrate PDMPs into their system design
  • States should individually provide links to their PDMPs from major certified EHR platforms
  • Reduce incomplete or unavailable data to increase PDMP use
  • Encourage states to establish interoperability between PDMP and EHR platforms and enable the VA and the military health system to report on a consistent basis
  • EHR vendors should work to integrate PDMPs into their system design at minimal to no additional cost or burden to providers
  • Clinicians within and outside federal healthcare entities should have access to each other’s data to ensure safe continuity of care

 

It was found that prescribers are more likely to use PDMPs presenting data in real time, are used by all prescribers, are technically easy to use without time constraints, and actively able to identify potential problems such as multiple prescribers or multiple prescription.

Go to https://www.hhs.gov/sites/default/files/pain-mgmt-best-practices-draft-final-report-05062019.pdf for the draft final report “Pain Management Best Practices”.

 

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