2033 lines
91 KiB
Text
2033 lines
91 KiB
Text
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<meta name="description" content="The purpose of this change package, known as the Compendium, is to support efforts by primary care practices and healthcare systems to improve opioid medication management and prevent opioid misuse and opioid use disorder in older adults in primary care. The Compendium offers key activities with tools and resources that practices and systems can use in their improvement efforts.Some items in the compendium include links to commercial sites, and inclusion of these items does not imply endorsement of any commercial websites by AHRQ, HHS, or the federal government." />
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<div class="clearfix text-formatted field field--name-body field--type-text-with-summary field--label-hidden field__item"><h2><a href="//www.ahrq.gov/research/findings/nhqrdr/index.html">National Healthcare Quality and Disparities Report</a></h2>
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<ul>
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<li><a href="/funding/policies/nofoguidance/index.html">Notice of Funding Opportunity Guidance</a></li>
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<li><a href="/funding/priorities-contacts/special-emphasis-notices/index.html">Special Emphasis Notices</a></li>
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<div class="content">
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<div class="clearfix text-formatted field field--name-body field--type-text-with-summary field--label-hidden field__item"><h2><a href="/funding/process/index.html">Grant Application, Review & Award Process</a></h2>
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<ul>
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<li><a href="/funding/process/grant-app-basics/index.html">Grant Application Basics</a></li>
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<li><a href="/funding/process/grant-app-basics/apptips.html">AHRQ Tips for Grant Applicants</a></li>
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|
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<li><a href="/funding/process/review/index.html">Application Receipt & Review</a></li>
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<div class="content">
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<ul>
|
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<li><a href="/funding/grantee-profiles/index.html">AHRQ Grantee Profiles</a></li>
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<li><a href="/funding/grant-mgmt/recognition_ahrq-funded_study.html">Getting Recognition for Your AHRQ-Funded Study</a></li>
|
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<li><a href="/funding/grant-mgmt/grants-by-state.html">Grants by State</a></li>
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<div class="content">
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<div class="clearfix text-formatted field field--name-body field--type-text-with-summary field--label-hidden field__item"><h2><a href="/funding/contracts/index.html">Contracts</a></h2>
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<ul></ul></div>
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</section>
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<div class="content">
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<div class="clearfix text-formatted field field--name-body field--type-text-with-summary field--label-hidden field__item"><h2><a href="/funding/grant-mgmt/grants-by-state.html">AHRQ Grants by State</a></h2>
|
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|
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<ul>
|
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</ul>
|
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|
||
<p>Searchable database of AHRQ Grants</p></div>
|
||
|
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</div>
|
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</div>
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<h1 class="node__title">
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<span property="schema:name" class="field field--name-title field--type-string field--label-hidden">Opioids in Older Adults Compendium</span>
|
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<div property="schema:text" class="clearfix text-formatted field field--name-body field--type-text-with-summary field--label-hidden field__item"><p>The purpose of this change package, known as the Compendium, is to support efforts by primary care practices and healthcare systems to improve opioid medication management and prevent opioid misuse and opioid use disorder in older adults in primary care. The Compendium offers key activities with tools and resources that practices and systems can use in their improvement efforts.</p><p>Some items in the compendium include links to commercial sites, and inclusion of these items does not imply endorsement of any commercial websites by AHRQ, HHS, or the federal government.</p></div>
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<div id="block-ahrq-compendium" class="block block-ahrq-compendium">
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<div class="compendium-content">
|
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<div class="row">
|
||
<div class="col-xl-9">
|
||
|
||
<figure class="org-chart cf">
|
||
<div class="row">
|
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<div class="col-xl-2">
|
||
<ul class="aim">
|
||
<li class="border rounded top">
|
||
<a href="#aim-top" data-ahrq-compendium="true">
|
||
<strong>AIM Statement</strong>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded aim-2">
|
||
<a href="#aim" data-ahrq-compendium="true">
|
||
<strong>Aim Statement</strong>
|
||
<p>Improve opioid medication management in older adults.</p>
|
||
</a>
|
||
</li>
|
||
</ul>
|
||
</div>
|
||
<div class="col-xl-4">
|
||
<ul class="hlc">
|
||
<li class="border rounded top">
|
||
<a href="#hlc-top" data-ahrq-compendium="true">
|
||
<strong>High Leverage Changes</strong>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded hlc-2" data-level="2" data-tid="14894" data-parent-tid="0">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#hlc" data-ahrq-compendium="true">
|
||
<strong>HLC: Opioid Data</strong>
|
||
<p>Identify, track, and monitor the use of opioids in older adults.</p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded hlc-2" data-level="2" data-tid="14903" data-parent-tid="0">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#hlc" data-ahrq-compendium="true">
|
||
<strong>HLC: Processes and Workflows</strong>
|
||
<p>Develop workflows that define roles and responsibilities, promote coordinated team-based care management for older adults on opioids.
|
||
</p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded hlc-2" data-level="2" data-tid="14914" data-parent-tid="0">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#hlc" data-ahrq-compendium="true">
|
||
<strong>HLC: Risk Assessment</strong>
|
||
<p>Use appropriate tools and workflows to assess the risks of opioid treatments: delirium, falls, opioid use disorder, etc.
|
||
</p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded hlc-2" data-level="2" data-tid="14924" data-parent-tid="0">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#hlc" data-ahrq-compendium="true">
|
||
<strong>HLC: OUD Assessment and Treatment</strong>
|
||
<p>Assess opioid use disorder in older adults and provide evidence-based treatment for those who meet criteria.
|
||
</p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded hlc-2" data-level="2" data-tid="14933" data-parent-tid="0">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#hlc" data-ahrq-compendium="true">
|
||
<strong>HLC: Patient Engagement</strong>
|
||
<p>Use shared decision making and patient-centered goal-setting to develop individualized care plans and provide care.
|
||
</p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded hlc-2" data-level="2" data-tid="14944" data-parent-tid="0">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#hlc" data-ahrq-compendium="true">
|
||
<strong>HLC: Nonpharmacologic Pain Management Approaches</strong>
|
||
<p>Increase referrals and access to nonpharmacologic chronic pain management such as self-management support and community resources.
|
||
</p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded hlc-2" data-level="2" data-tid="14953" data-parent-tid="0">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#hlc" data-ahrq-compendium="true">
|
||
<strong>HLC: Medication Management</strong>
|
||
<p>Integrate robust medication management protocols and patient guidance (e.g., medication reconciliation, tapering protocols, treatment agreements, and medication fact sheets).
|
||
</p>
|
||
</a>
|
||
</li>
|
||
</ul>
|
||
</div>
|
||
<div class="col-xl-3">
|
||
<ul class="strategy">
|
||
<li class="border rounded top">
|
||
<a href="#strategy-top" data-ahrq-compendium="true">
|
||
<strong>Change Strategy</strong>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded strategy-2" data-level="3" data-tid="14895" data-parent-tid="14894">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#strategy" data-ahrq-compendium="true">
|
||
<strong>Implement System Administration Activities</strong>
|
||
<p></p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded strategy-2" data-level="3" data-tid="14898" data-parent-tid="14894">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#strategy" data-ahrq-compendium="true">
|
||
<strong>Train/Educate Clinicians & Staff</strong>
|
||
<p></p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded strategy-2" data-level="3" data-tid="14900" data-parent-tid="14894">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#strategy" data-ahrq-compendium="true">
|
||
<strong>Integrate Equity</strong>
|
||
<p></p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded strategy-2" data-level="3" data-tid="14904" data-parent-tid="14903">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#strategy" data-ahrq-compendium="true">
|
||
<strong>Implement System Administration Activities</strong>
|
||
<p></p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded strategy-2" data-level="3" data-tid="14908" data-parent-tid="14903">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#strategy" data-ahrq-compendium="true">
|
||
<strong>Train/Educate Clinicians & Staff</strong>
|
||
<p></p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded strategy-2" data-level="3" data-tid="14912" data-parent-tid="14903">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#strategy" data-ahrq-compendium="true">
|
||
<strong>Integrate Equity</strong>
|
||
<p></p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded strategy-2" data-level="3" data-tid="14915" data-parent-tid="14914">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#strategy" data-ahrq-compendium="true">
|
||
<strong>Implement System Administration Activities</strong>
|
||
<p></p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded strategy-2" data-level="3" data-tid="14918" data-parent-tid="14914">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#strategy" data-ahrq-compendium="true">
|
||
<strong>Train/Educate Clinicians & Staff</strong>
|
||
<p></p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded strategy-2" data-level="3" data-tid="14920" data-parent-tid="14914">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#strategy" data-ahrq-compendium="true">
|
||
<strong>Engage with the Patient</strong>
|
||
<p></p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded strategy-2" data-level="3" data-tid="14922" data-parent-tid="14914">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#strategy" data-ahrq-compendium="true">
|
||
<strong>Integrate Equity</strong>
|
||
<p></p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded strategy-2" data-level="3" data-tid="14925" data-parent-tid="14924">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#strategy" data-ahrq-compendium="true">
|
||
<strong>Implement System Administration Activities</strong>
|
||
<p></p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded strategy-2" data-level="3" data-tid="14927" data-parent-tid="14924">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#strategy" data-ahrq-compendium="true">
|
||
<strong>Train/Educate Clinicians & Staff</strong>
|
||
<p></p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded strategy-2" data-level="3" data-tid="14929" data-parent-tid="14924">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#strategy" data-ahrq-compendium="true">
|
||
<strong>Engage with the Patient</strong>
|
||
<p></p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded strategy-2" data-level="3" data-tid="14931" data-parent-tid="14924">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#strategy" data-ahrq-compendium="true">
|
||
<strong>Integrate Equity</strong>
|
||
<p></p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded strategy-2" data-level="3" data-tid="14934" data-parent-tid="14933">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#strategy" data-ahrq-compendium="true">
|
||
<strong>Implement System Administration Activities</strong>
|
||
<p></p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded strategy-2" data-level="3" data-tid="14936" data-parent-tid="14933">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#strategy" data-ahrq-compendium="true">
|
||
<strong>Train/Educate Clinicians & Staff</strong>
|
||
<p></p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded strategy-2" data-level="3" data-tid="14938" data-parent-tid="14933">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#strategy" data-ahrq-compendium="true">
|
||
<strong>Engage with the Patient</strong>
|
||
<p></p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded strategy-2" data-level="3" data-tid="14940" data-parent-tid="14933">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#strategy" data-ahrq-compendium="true">
|
||
<strong>Integrate Equity</strong>
|
||
<p></p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded strategy-2" data-level="3" data-tid="14945" data-parent-tid="14944">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#strategy" data-ahrq-compendium="true">
|
||
<strong>Implement System Administration Activities</strong>
|
||
<p></p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded strategy-2" data-level="3" data-tid="14947" data-parent-tid="14944">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#strategy" data-ahrq-compendium="true">
|
||
<strong>Train/Educate Clinicians & Staff</strong>
|
||
<p></p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded strategy-2" data-level="3" data-tid="14949" data-parent-tid="14944">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#strategy" data-ahrq-compendium="true">
|
||
<strong>Engage with the Patient</strong>
|
||
<p></p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded strategy-2" data-level="3" data-tid="14951" data-parent-tid="14944">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#strategy" data-ahrq-compendium="true">
|
||
<strong>Integrate Equity</strong>
|
||
<p></p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded strategy-2" data-level="3" data-tid="14954" data-parent-tid="14953">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#strategy" data-ahrq-compendium="true">
|
||
<strong>Implement System Administration Activities</strong>
|
||
<p></p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded strategy-2" data-level="3" data-tid="14957" data-parent-tid="14953">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#strategy" data-ahrq-compendium="true">
|
||
<strong>Train/Educate Clinicians & Staff</strong>
|
||
<p></p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded strategy-2" data-level="3" data-tid="14959" data-parent-tid="14953">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#strategy" data-ahrq-compendium="true">
|
||
<strong>Engage with the Patient</strong>
|
||
<p></p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded strategy-2" data-level="3" data-tid="14961" data-parent-tid="14953">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#strategy" data-ahrq-compendium="true">
|
||
<strong>Integrate Equity</strong>
|
||
<p></p>
|
||
</a>
|
||
</li>
|
||
</ul>
|
||
</div>
|
||
<div class="col-xl-3">
|
||
|
||
<ul class="activity">
|
||
<li class="border rounded top">
|
||
<a href="#activity-top" data-ahrq-compendium="true">
|
||
<strong>Key Activities</strong>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded activity-2" data-level="4" data-tid="14896" data-parent-tid="14895">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#activity" data-ahrq-compendium="true">
|
||
<span class="d-none">Implement System Administration Activities - Create a monthly report</span>
|
||
<p>Create a monthly report with specific quality metrics about opioid use in older adults. Use report to provide feedback to clinicians about their performance.</p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded activity-2" data-level="4" data-tid="14897" data-parent-tid="14895">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#activity" data-ahrq-compendium="true">
|
||
<span class="d-none">Implement System Administration Activities - Create clinician-specific list</span>
|
||
<p>Create a clinician-specific list of all patients over age 65 who have recently received an opioid refill. Discuss these lists at the next clinician meeting.</p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded activity-2" data-level="4" data-tid="14899" data-parent-tid="14898">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#activity" data-ahrq-compendium="true">
|
||
<span class="d-none">Train/Educate Clinicians & Staff - Use data to educate clinicians and staff</span>
|
||
<p>Use data to educate clinicians and staff about opioid use in your older adult population and provide them with monthly updates (e.g., number on long term opioid therapy (LTOT), number co-prescribed opioids & benzodiazepines, and number of patients with ≥50 morphine milligram equivalents (MME)/day).</p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded activity-2" data-level="4" data-tid="14901" data-parent-tid="14900">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#activity" data-ahrq-compendium="true">
|
||
<span class="d-none">Integrate Equity - Stratify opioid use metrics</span>
|
||
<p>Stratify opioid use metrics for older adults by race/ethnicity, gender, socio-economic status, sexual orientation, and other key demographic characteristics that are most relevant to the population you serve. </p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded activity-2" data-level="4" data-tid="14902" data-parent-tid="14900">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#activity" data-ahrq-compendium="true">
|
||
<span class="d-none">Integrate Equity - Incorporate data to the social determinants of health</span>
|
||
<p>Incorporate data related to the social determinants of health and how they may be affecting outcomes among older adults in your quality improvement efforts</p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded activity-2" data-level="4" data-tid="14905" data-parent-tid="14904">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#activity" data-ahrq-compendium="true">
|
||
<span class="d-none">Implement System Administration Activities - Develop care gap reports</span>
|
||
<p>Develop care gap reports (such report identifies missing recommended care services so that the clinician may address them at the next patient visit) for older adults on opioids and design workflows to address them.</p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded activity-2" data-level="4" data-tid="14906" data-parent-tid="14904">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#activity" data-ahrq-compendium="true">
|
||
<span class="d-none">Implement System Administration Activities - Designate a clinician champion</span>
|
||
<p>Designate a clinician champion to improve guideline-concordant care for managing opioids in older adults.</p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded activity-2" data-level="4" data-tid="14907" data-parent-tid="14904">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#activity" data-ahrq-compendium="true">
|
||
<span class="d-none">Implement System Administration Activities - Establish multi-disciplinary opioid review committee</span>
|
||
<p><p>Establish a multi-disciplinary opioid review committee focused on older adults to review charts/cases and make recommendations for improving opioid medication management.</p>
|
||
</p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded activity-2" data-level="4" data-tid="14909" data-parent-tid="14908">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#activity" data-ahrq-compendium="true">
|
||
<span class="d-none">Train/Educate Clinicians & Staff - Educate staff</span>
|
||
<p>Educate staff who are unfamiliar with potential risks and misuse of opioids in older adults.</p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded activity-2" data-level="4" data-tid="14910" data-parent-tid="14908">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#activity" data-ahrq-compendium="true">
|
||
<span class="d-none">Train/Educate Clinicians & Staff - Develop specific workflows</span>
|
||
<p>Develop specific workflows to screen for opioid use related risks in older adults, such as falls and cognitive impairment.</p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded activity-2" data-level="4" data-tid="14911" data-parent-tid="14908">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#activity" data-ahrq-compendium="true">
|
||
<span class="d-none">Train/Educate Clinicians & Staff - Train staff on workflow</span>
|
||
<p>Train staff on workflow to screen for falls, cognitive impairment, and other risks in older adults on opioids.</p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded activity-2" data-level="4" data-tid="14913" data-parent-tid="14912">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#activity" data-ahrq-compendium="true">
|
||
<span class="d-none">Integrate Equity - Have a critical review process</span>
|
||
<p>Have a critical review process for new and existing structures, policies and procedures in your clinic that assesses their impact on equity, inclusion, and diversity.</p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded activity-2" data-level="4" data-tid="14916" data-parent-tid="14915">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#activity" data-ahrq-compendium="true">
|
||
<span class="d-none">Implement System Administration Activities - Develop a consensus</span>
|
||
<p>Develop a consensus among clinicians and staff about what to screen for in older adults using opioids, including how often screening should take place, who does the screening, and how it is documented.</p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded activity-2" data-level="4" data-tid="14917" data-parent-tid="14915">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#activity" data-ahrq-compendium="true">
|
||
<span class="d-none">Implement System Administration Activities - Integrate fall risk assessment</span>
|
||
<p>Integrate fall risk assessment into routine care for older adults on opioids.</p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded activity-2" data-level="4" data-tid="14919" data-parent-tid="14918">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#activity" data-ahrq-compendium="true">
|
||
<span class="d-none">Train/Educate Clinicians & Staff - Train about opioid related risks</span>
|
||
<p>Train clinicians and staff about opioid related risks (e.g., falls) and how to screen for them during a visit.</p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded activity-2" data-level="4" data-tid="14921" data-parent-tid="14920">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#activity" data-ahrq-compendium="true">
|
||
<span class="d-none">Engage with the Patient - Discuss results of fall risk assessment</span>
|
||
<p>Discuss results of fall risk assessment with patients and provide them with tools/resources to reduce their risk.</p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded activity-2" data-level="4" data-tid="14923" data-parent-tid="14922">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#activity" data-ahrq-compendium="true">
|
||
<span class="d-none">Integrate Equity - Discuss which patients within your clinic are at elevated risk</span>
|
||
<p>Discuss which patients within your clinic are at elevated risk of adverse effects from opioids and how you might address the risks.</p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded activity-2" data-level="4" data-tid="14926" data-parent-tid="14925">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#activity" data-ahrq-compendium="true">
|
||
<span class="d-none">Implement System Administration Activities - Develop and implement an opioid treatment agreement</span>
|
||
<p>Develop and implement an opioid treatment agreement customized for older adults (e.g., describes specific risks to older adults and incorporates caregivers’ responsibilities).</p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded activity-2" data-level="4" data-tid="14928" data-parent-tid="14927">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#activity" data-ahrq-compendium="true">
|
||
<span class="d-none">Train/Educate Clinicians & Staff - Educate about potential signs and symptoms</span>
|
||
<p>Educate clinicians and staff about potential signs and symptoms of opioid misuse in the older adult.</p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded activity-2" data-level="4" data-tid="14930" data-parent-tid="14929">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#activity" data-ahrq-compendium="true">
|
||
<span class="d-none">Engage with the Patient - Make tools and resources available</span>
|
||
<p>Make tools and resources available to patients to help them understand OUD.</p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded activity-2" data-level="4" data-tid="14932" data-parent-tid="14931">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#activity" data-ahrq-compendium="true">
|
||
<span class="d-none">Integrate Equity - Address stigma and bias</span>
|
||
<p>Address stigma and bias in the recognition and treatment of OUD among older adults through staff training.</p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded activity-2" data-level="4" data-tid="14935" data-parent-tid="14934">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#activity" data-ahrq-compendium="true">
|
||
<span class="d-none">Implement System Administration Activities - Use templates for documenting patient goals</span>
|
||
<p>Use templates for documenting patient goals for managing chronic pain.</p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded activity-2" data-level="4" data-tid="14937" data-parent-tid="14936">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#activity" data-ahrq-compendium="true">
|
||
<span class="d-none">Train/Educate Clinicians & Staff - Train on patient engagement techniques</span>
|
||
<p>Train clinicians and staff on patient engagement techniques, such as shared decision-making and goal-oriented care, specific to older adults.</p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded activity-2" data-level="4" data-tid="14939" data-parent-tid="14938">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#activity" data-ahrq-compendium="true">
|
||
<span class="d-none">Engage with the Patient - Establish workflows to elicit and document patient goals</span>
|
||
<p>Establish workflows and use templates to elicit and document patient goals for managing chronic pain.</p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded activity-2" data-level="4" data-tid="14941" data-parent-tid="14940">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#activity" data-ahrq-compendium="true">
|
||
<span class="d-none">Integrate Equity - Ensure tools and resources are available in language and literacy level</span>
|
||
<p>Ensure that any shared decision-making tools and educational resources used in making decisions are available in the appropriate language and literacy level.</p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded activity-2" data-level="4" data-tid="14942" data-parent-tid="14940">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#activity" data-ahrq-compendium="true">
|
||
<span class="d-none">Integrate Equity - Discuss impact of stigma</span>
|
||
<p>Openly discuss the impact of stigma, biases, and assumptions on equity in the use of shared decision making for older adults regarding opioids and/or chronic pain.</p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded activity-2" data-level="4" data-tid="14943" data-parent-tid="14940">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#activity" data-ahrq-compendium="true">
|
||
<span class="d-none">Integrate Equity - Use 'teach-back' for changes in medication</span>
|
||
<p>Use “teach-back” or other communication techniques to ensure that the patient and/or caregiver clearly understand any change in medications. While “teach back” technique is not specific to older adults or opioids management, it is an evidence-based health literacy intervention.</p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded activity-2" data-level="4" data-tid="14946" data-parent-tid="14945">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#activity" data-ahrq-compendium="true">
|
||
<span class="d-none">Implement System Administration Activities - Identify nonpharmacologic treatment modalities</span>
|
||
<p><p>Identify nonpharmacologic treatment modalities for chronic pain in the older adult population and develop referral workflows and tracking to ensure the referral is completed.</p>
|
||
</p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded activity-2" data-level="4" data-tid="14948" data-parent-tid="14947">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#activity" data-ahrq-compendium="true">
|
||
<span class="d-none">Train/Educate Clinicians & Staff - Ensure utilization of evidence-based nonpharmacologic treatments</span>
|
||
<p><p>Ensure that clinicians and staff understand, recommend, and utilize evidence-based nonpharmacologic treatments for chronic pain.</p>
|
||
</p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded activity-2" data-level="4" data-tid="14950" data-parent-tid="14949">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#activity" data-ahrq-compendium="true">
|
||
<span class="d-none">Engage with the Patient - Provide information about nonpharmacologic pain treatments</span>
|
||
<p><p>Provide patients with information about nonpharmacologic pain treatments (e.g., physical therapy, hydrotherapy, tai-chi, and yoga).</p>
|
||
</p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded activity-2" data-level="4" data-tid="14952" data-parent-tid="14951">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#activity" data-ahrq-compendium="true">
|
||
<span class="d-none">Integrate Equity - Assess social determinants of health</span>
|
||
<p>Assess social determinants of health among older adult populations, as they are often a key factor in a successful referral (e.g., transportation, social support, insurance coverage).</p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded activity-2" data-level="4" data-tid="14955" data-parent-tid="14954">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#activity" data-ahrq-compendium="true">
|
||
<span class="d-none">Implement System Administration Activities - Integrate routine medication management</span>
|
||
<p><p>Integrate routine medication management and reviews into pain visits:</p>
|
||
|
||
<p>- screening appropriate for older adults on opioids such as falls risk,</p>
|
||
<p>- calculating Morphine Milligram Equivalents,</p>
|
||
<p>- monitoring with urine drug testing (UDT),</p>
|
||
<p>- assessing pain and function to determine effectiveness of current treatment regimen (including opioid, non-opioid, and nonpharmacological therapies),</p>
|
||
<p>- considering naloxone co-prescribing for patients on long-term opioid therapy,</p>
|
||
<p>- ordering appropriate labs.</p>
|
||
</p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded activity-2" data-level="4" data-tid="14956" data-parent-tid="14954">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#activity" data-ahrq-compendium="true">
|
||
<span class="d-none">Implement System Administration Activities - Follow evidence-based guidelines</span>
|
||
<p>Follow evidence-based guidelines for prescribing, monitoring, de-prescribing and otherwise managing opioids in older adults.</p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded activity-2" data-level="4" data-tid="14958" data-parent-tid="14957">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#activity" data-ahrq-compendium="true">
|
||
<span class="d-none">Train/Educate Clinicians & Staff - Provide opportunities to discuss challenging clinical scenarios</span>
|
||
<p>Provide opportunities for clinicians and staff to discuss challenging clinical scenarios about managing opioids with their older adult patients.</p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded activity-2" data-level="4" data-tid="14960" data-parent-tid="14959">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#activity" data-ahrq-compendium="true">
|
||
<span class="d-none">Engage with the Patient - Create an after-visit summary</span>
|
||
<p>Create an after-visit summary for older adults that includes instructions on safe use and storage of opioid medications.</p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded activity-2" data-level="4" data-tid="14962" data-parent-tid="14961">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#activity" data-ahrq-compendium="true">
|
||
<span class="d-none">Integrate Equity - Medication management discussions</span>
|
||
<p>Medication management discussions need to be inclusive of patients and their caregivers and should recognize the experiences and realities that may affect how medication is managed in their own unique situation.</p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded activity-2" data-level="4" data-tid="14963" data-parent-tid="14961">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#activity" data-ahrq-compendium="true">
|
||
<span class="d-none">Integrate Equity - Communication techniques</span>
|
||
<p>Communication techniques must consider various levels of health literacy, linguistic diversity, and should foster open and approachable discussion.</p>
|
||
</a>
|
||
</li>
|
||
<li class="border rounded activity-2" data-level="4" data-tid="14964" data-parent-tid="14961">
|
||
<div class="arrow-wrapper"></div>
|
||
<a href="#activity" data-ahrq-compendium="true">
|
||
<span class="d-none">Integrate Equity - Materials which are culturally and linguistically representative</span>
|
||
<p>In addition to oral communication, ensure clinicians and staff have materials available on medication management that have language and photos which are culturally and linguistically representative of the populations they serve and are easy to understand</p>
|
||
</a>
|
||
</li>
|
||
</ul>
|
||
</div>
|
||
</div><!-- row -->
|
||
</figure>
|
||
</div>
|
||
<div class="col-xl-3 resources">
|
||
<div id="compendium-tools-resources">
|
||
</div>
|
||
</div>
|
||
</div>
|
||
|
||
</div>
|
||
|
||
</div>
|
||
</div>
|
||
|
||
|
||
</div>
|
||
|
||
|
||
</div>
|
||
</div>
|
||
|
||
<div class="row">
|
||
<div class="col-md-12 col-sm-12 text-right">
|
||
<section class="row region region-citation">
|
||
<div id="block-citation" class="block block-ahrq block-citation">
|
||
|
||
|
||
<div class="content">
|
||
<div id="created-reviewed-citation" class="pad-bottom-sections">
|
||
<div id="page-reviewed" class="body-copy-italic">Page last reviewed November 2024 </div>
|
||
<div id="page-created" class="body-copy-italic">Page originally created December 2023</div>
|
||
</div>
|
||
|
||
<div id="citation">
|
||
<div class="twocolordiv">
|
||
<div class="twocolordiv-content">
|
||
<p>
|
||
<span class="citation-hdr">Internet Citation:</span> Opioids in Older Adults Compendium. Content last reviewed November 2024. Agency for Healthcare Research and Quality, Rockville, MD.<br>
|
||
<span class="citation-url">https://www.ahrq.gov/opioids/implementing-what-works/compendium.html</span>
|
||
</p></div>
|
||
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|
||
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|
||
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<img alt="Go back to top"
|
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height="25"
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width="25">
|
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