Becker's Hospital Review

157 FINANCE CMO / CARE DELIVERY 5:06 PM Intermountain to Cut Opioid Prescriptions 40% by End of 2018: 5 Things to Know By Brian Zimmerman S alt Lake City-based Intermountain Healthcare aims to achieve a 40 per- cent reduction in the number of opi- oids prescribed for acute pain systemwide by the end of 2018. Intermountain announced the goal Aug. 22, making it the first health system to formally make such a specific and substantial pledge for opioid prescription reduction. Here are five things to know. 1. To achieve the reduction, Intermountain has already trained about 2,500 prescribers in opi- oid reduction strategies. e system plans to extend this training to each of its 22 hospitals and 180 clinics throughout Utah and Idaho. 2. e system will also provide new tools and policies to help prescribers reduce the number of opioids prescribed by 5 million tablets annually. "Currently, nationwide, providers tend to write prescriptions for more opioids than pa- tients need, and large quantities of the med- ications are oen le over aer the need for pain relief is past," said Doug Smith, MD, associate medical director for Intermountain Healthcare. "We will follow best practices in prescribing so the medications prescribed more closely match the needs of patients." 3. Dr. Smith added that both chronic and acute pain patients will continue to have ac- cess to the medications they need. "We will ensure patients have access to the full range of options to manage pain," Dr. Smith said. 4. Todd Allen, MD, acting chief quality officer for the network of hospitals and clinics, told e Salt Lake Tribune he recognized the risk associated with putting a hard number on the reduction goal, but said it is a way for the sys- tem to hold itself accountable. "We won't be timid anymore," Dr. Allen told e Salt Lake Tribune. "We plan on making a big difference." 5. In Utah, 24 people died every month from prescription opioid overdoses in 2015, ac- cording to data from the Utah Department of Health cited by e Salt Lake Tribune. n Physicians From Lower-Tier Med Schools Prescribe More Opioids By Brian Zimmerman P hysicians educated at top medical schools prescribe fewer opioids than those educated at lower-ranked medical schools, according to a working paper published by the National Bureau of Economic Research. To assess the influence of medical education on opioid prescribing prac- tices, economics professors at Princeton (N.J.) University examined data on all opioid prescriptions written between 2006 and 2014. The research- ers also used a composite ranking of medical schools based on several years of U.S. News and World Report rankings. A comprehensive assess- ment of both datasets indicated the propensity to prescribe opioids was higher among physicians educated at lower-tier medical schools when compared to physicians educated at top medical schools. This associa- tion persisted across regions and medical specialties. Among physicians across specialties who attended Boston-based Har- vard Medical School, on average, wrote fewer than 100 opioid pre- scriptions per year. Physicians across all specialties educated at the lowest-ranked schools averaged about 300 opioid prescriptions annu- ally. Among general practitioners, the average Harvard graduate wrote 180.2 opioid prescriptions each year, while graduates from lower-ranked schools wrote an average of 550. "Taken together, our findings suggest that a doctor's initial training has a large impact on their attitudes towards opioid prescribing, especially for [general practitioners]," concluded the study's authors. "Since variations in opioid prescribing have contributed to deaths due to the current opi- oid epidemic, training aimed at reducing prescribing rates among the most liberal prescribers — who disproportionately come from the lowest ranked medical schools — could possibly have large public health bene- fits. Physician education therefore likely has a role to play in addressing the opioid epidemic." n Study: Opioid Use Linked to 20% of Overall Decline in Male Labor Force By Brian Zimmerman O pioid use may be attributable to 20 percent of the overall decline in men's participation in the U.S. work- force, according to a paper authored by Alan Krueger, PhD, an economics professor at Princeton (N.J.) University. Dr. Krueger's paper analyzes the driving forces behind declining labor force partici- pation numbers, which peaked in 2000. As a part of the study, Dr. Krueger compared survey data compiled by the National Bu- reau of Labor Statistics with county level prescribing rates compiled by the CDC over the last 15 years. Analysis revealed 44 percent of working age men out of the labor force reported use of pain medication, nearly double the rate of pain medication usage among employed men. "Labor force participation has fallen more in areas where relatively more opioid pain medication is prescribed, causing the prob- lem of depressed labor force participa- tion and the opioid crisis to become inter- twined," wrote Dr. Krueger. n

• Cover