Journal of pain and symptom management | 2021

Feasibility of Safe Opioid Prescribing in Outpatient Palliative Care: A Quality Improvement Project.



BACKGROUND\nNo guidelines for safe opioid prescribing in palliative care exist, which contributes to limited monitoring of opioid misuse in palliative care.\n\n\nMEASURES\nFeasibility of a safe opioid prescribing standard operating protocol (SOP) was determined by assessing the percentage of patients in an outpatient cancer center who completed each component of a five-component SOP.\n\n\nINTERVENTION\nA five-component SOP included: risk stratification for misuse, consent form, prescription drug monitoring program review, urine drug testing, and Naloxone for high-risk individuals.\n\n\nOUTCOMES\nAfter one year, compliance rates on four of the of the five-component SOP were greater or equal to 93%. Naloxone co-prescription for high-risk patients never reached over 78%, largely due to clinical decision not to co-prescribe if transition to hospice was imminent.\n\n\nCONCLUSIONS/LESSONS LEARNED\nSafe opioid prescribing measures is feasible in outpatient palliative care and can facilitate identification of individuals at risk for opioid misuse and prompt early interventions for misuse.

Volume None
Pages None
DOI 10.1016/j.jpainsymman.2021.02.006
Language English
Journal Journal of pain and symptom management

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