Randall Brown, MD, PhD, FASAM, an associate professor at the UW Department of Family Medicine (DFM) and Andrew Quanbeck, PhD, a systems engineer at the UW Department of Industrial and Systems Engineering, want to improve how opioid prescribing guidelines are implemented in clinical practice.
As joint principal investigators on a three-year National Institute on Drug Abuse-funded study, they will pilot a quality improvement model called Network for Improvement of Addiction Treatment approach to reducing Variation in Opioid Prescribing, or NIATx-VOP. The new model builds on an earlier proven method of quality improvement that applies systems engineering principles to addiction treatment.
Their work addresses one of the most urgent public health concerns today: prescription opioid abuse. Although clinical guidelines for prescribing opioids for chronic non-cancer pain have been developed, they are inconsistently implemented in practice.
The project brings together Dr. Brown, Dr. Quanbeck, and an advisory board of internationally recognized experts in pain management, implementation science, primary care, and drug policy.
Together, using the NIATx-VOP model, they will translate existing guidelines into an actionable, checklist-based implementation guide. Dr. Brown, along with DFM Assistant Professor and project co-investigator Aleksandra Zgierska, MD, PhD, will be trained as physician peer coaches and will help field-test adaptation of the implementation guide at four primary care clinics in Wisconsin.
“Peer-to-peer physician coaching is a cornerstone of NIATx-VOP, and we believe it’s critical for changing clinical practice,” Dr. Brown explained. “Interventions designed to increase the use of evidence-based practice have been shown to improve process, but not clinical outcomes. Changing clinical practice requires the involvement of physicians—and physicians are more likely to be influenced by other physicians.”
In the final year of the project, the team will analyze data collected from those field tests, publish results and prepare for a subsequent randomized trial that will test the new model against other methods used to spread evidence-based practice in primary care.
“If this model proves more successful in moving evidence-based changes into practice than methods currently used, we’ll not just reduce the burdens caused by opioid misuse and addiction, but also offer an approach to improve healthcare generally,” Dr. Brown added.
Published: October 2014