The 4Ms of Age-Friendly Care: Successful Infusion into Electronic Medical Records Leads to Improved Care

Abstract Electronic Medical Records (EMR) and Health Information Technology (HIT) have changed the daily operations of the healthcare industry. For primary care systems/clinics, it has meant the purchase and tailoring of systems to fit specific needs of users and patients. As one of the HRSA funded Geriatric Workforce Enhancement recipients, the AR Geriatric Education Collaborative (AGEC) worked with a rural federally qualified healthcare clinic system for over a year to help them become IHI certified in Age-Friendly Care and the EMR has been a critical link. The system was crucial in identifying compliancy to the clinical Merit-based Incentive Payment System (MIPS) measures which helped identify the areas where most improvement was needed. Included in the process was a new geriatric screening tab in the EMR system. This tab contains 8 screenings including: depression, anxiety, alcohol use, prescription opioid use and recreational drug use, mentation, medication and mobility. This is in addition to asking “what matters” so that all four of the 4M’s age friendly framework components were included. Clinicians are successfully using the systems and improvements in outcomes are beginning to be noted. The outcome MIPS measures are obtained quarterly from an EMR report and data is shared with the staff and new quality improvement projects are developed using PDSA (plan, do, study, act) cycles based on the outcomes of the data. Next steps with the EMR will be the development of flags that will notify the clinicians when a screening is needed.

Download Full-text

A new OPIATE (Optimizing Positive Ibuprofen and Acetaminophen Treatment Expectations) model: A brief comment on “Concurrent and lagged associations of prescription opioid use with pain and negative affect in the daily lives of chronic pain patients” (Carpenter, Lane, Bruehl, & Trull, 2019).

Journal of Consulting and Clinical Psychology ◽

10.1037/ccp0000436 ◽

2019 ◽

Vol 87 (10) ◽

pp. 887-892

Author(s):

Jack Stevens ◽

Tarun Bhalla

Keyword(s):

Chronic Pain ◽

Negative Affect ◽

Prescription Opioid ◽

Opioid Use ◽

Treatment Expectations ◽

Daily Lives ◽

Chronic Pain Patients ◽

Prescription Opioid Use ◽

Pain Patients

Download Full-text

0049 Within-person predictors of same day alcohol and prescription opioid use among youth presenting to an urban emergency department

10.1136/injuryprev-2021-savir.30 ◽

2021 ◽

Author(s):

J Goldstick ◽

E Bonar ◽

M Myers ◽

A Bohnert ◽

M Walton ◽

...

Keyword(s):

Emergency Department ◽

Prescription Opioid ◽

Opioid Use ◽

Prescription Opioid Use ◽

Urban Emergency Department

Download Full-text

“Doctor and pharmacy shopping”: A fading signal for prescription opioid use monitoring?

Drug and Alcohol Dependence ◽

10.1016/j.drugalcdep.2021.108618 ◽

2021 ◽

Vol 221 ◽

pp. 108618

Author(s):

Chris Delcher ◽

Daniel R. Harris ◽

Changwe Park ◽

Gail K. Strickler ◽

Jeffery Talbert ◽

...

Keyword(s):

Prescription Opioid ◽

Opioid Use ◽

Prescription Opioid Use

Download Full-text

Opioid dosing among patients with 3 or more years of continuous prescription opioid use before and after the CDC opioid prescribing guideline

International Journal of Drug Policy ◽

10.1016/j.drugpo.2021.103308 ◽

2021 ◽

Vol 97 ◽

pp. 103308

Author(s):

Joanne Salas ◽

Xue Li ◽

Hong Xian ◽

Mark D. Sullivan ◽

Jane C. Ballantyne ◽

...

Keyword(s):

Prescription Opioid ◽

Opioid Use ◽

Opioid Prescribing ◽

Before And After ◽

Prescription Opioid Use

Download Full-text

Determining the influence of the Workers Compensation Board of Manitoba's opioid policy on prescription opioid use amongst WCB recipients

American Journal of Industrial Medicine ◽

10.1002/ajim.23216 ◽

2020 ◽

Author(s):

Allen Kraut ◽

Leigh Anne Shafer

Keyword(s):

Prescription Opioid ◽

Workers Compensation ◽

Opioid Use ◽

Prescription Opioid Use ◽

Opioid Policy

Download Full-text

The association of prescription opioid use with incident cancer: A surveillance, epidemiology, and end results‐medicare population‐based case‐control study

Cancer ◽

10.1002/cncr.33285 ◽

2020 ◽

Author(s):

Jeana E. Havidich ◽

Julie E. Weiss ◽

Tracy L. Onega ◽

Ying H. Low ◽

Martha E. Goodrich ◽

...

Keyword(s):

Case Control Study ◽

Population Based ◽

Case Control ◽

Prescription Opioid ◽

Opioid Use ◽

Medicare Population ◽

Incident Cancer ◽

Prescription Opioid Use ◽

Control Study ◽

End Results

Download Full-text

354 Trends in the Drug-Sparing Effects for Benzodiazepines and Prescription Opioids among Insomnia Patients on Suvorexant in the US

SLEEP ◽

10.1093/sleep/zsab072.353 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A141-A141

Author(s):

Hrishikesh Kale ◽

Rezaul Khandker ◽

Ruchit Shah ◽

Marc Botteman ◽

Weilin Meng ◽

...

Keyword(s):

Interrupted Time Series ◽

Charlson Comorbidity Index Score ◽

Prescription Opioid ◽

Prescription Opioids ◽

Opioid Use ◽

Before And After ◽

Prescription Opioid Use ◽

Incident Cohort ◽

Over Time ◽

Post Period

Abstract Introduction Use of benzodiazepines to treat insomnia has been associated with serious side effects and abuse potential. Insomnia patients are at high risk of opioid abuse and better sleep patterns may help to reduce opioid use. This study examined the trend in the use of benzodiazepines and prescription opioids before and after initiation of suvorexant in insomnia patients. Methods The study analyzed 2015–2019, Optum Clinformatics Data Mart. Insomnia patients, identified using ICD-9/10 codes and prescribed suvorexant were included. The study included incident (newly diagnosed) and prevalent cohorts of insomnia patients. The proportion of patients on benzodiazepines or prescription opioids were calculated for 12 monthly intervals before (pre-period) and after initiation of suvorexant (post-period). Interrupted time series (ITS) analysis was conducted to assess trends for use of benzodiazepine or prescription opioids over time. Results A total of 5,939 patients from the incident insomnia cohort and 18,920 from the prevalent cohort were included. For the incident cohort, mean age was 64.47 (SD: 15.48), 63% were females, 71% had Medicare Advantage coverage, 59% had Charlson comorbidity index score (CCI) ≥ 1, 27% had an anxiety disorder and 16% had substance abuse disorder. Prevalent insomnia cohort was similar but had higher CCI. Results from ITS suggested that at the beginning of the pre-period, 28% of incident insomnia patients used either opioids or benzodiazepines with the rate of use in the pre-period increasing by 0.11% per month. In the post-period, the rate of use decreased by 0.33% per month. About 26% patients used benzodiazepines or opioids at 12-month after suvorexant initiation. In the absence of suvorexant, this proportion would have been 31%. Similar findings were observed for the prevalent insomnia cohort. A larger decrease was observed for opioid use than benzodiazepines. Conclusion The rate of benzodiazepines or prescription opioid use decreased over time after the initiation of suvorexant. Suvorexant has the potential to reduce the use of opioids and benzodiazepines among insomnia patients. Further research is needed to confirm these findings. Support (if any) This study was sponsored by Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA.

Download Full-text