By Brenda L. Mooney

Mark Ilgen, PhD, a research investigator at the VA’s Center for Clinical Management Research and an associate professor of psychiatry at UM.

ANN ARBOR, MI — Thanks to a national initiative begun at the VHA in 2013, fewer veterans are receiving prescriptions for risky dosages of opioid painkillers.

Over a two-year period, according to a recent study, high-dose opioid prescribing declined by 16% and very-high-dose opioid prescribing dropped by 24% at the healthcare system. Furthermore, the number of patients receiving both opioids and sedatives, which can be lethal when combined, dropped by 21%.

The report published ahead of print in the journal Pain looks at the effect of the Opioid Safety Initiative (OSI) launched by the VHA in late 2013 to promote safer opioid prescribing. The study reviews implementation of the initiative across all of the nation’s 141 VA hospitals.¹

As part of the OSI, the VHA created a “dashboard” tool using its national computerized medical record system, which allowed local clinical leaders to systematically review opioid prescribing and give feedback to physicians.

The hope is that other large healthcare systems will begin to use their electronic medical systems as part of the fight against painkiller overdoses and opioid addictions, according to study authors from the VA Ann Arbor, MI, Healthcare System, the University of Michigan Medical School and Institute for Healthcare Policy and Innovation, both in Ann Arbor, MI, and Yale University in New Haven, CT.

The study of VA opioid prescribing actually begaN before the OSI rolled out and then extended through the program’s first year. While the national VA system had tried other efforts to stem risky opioid use, including guidelines for prescribing, the new research shows OSI greatly accelerated the downward trend.

“As our nation as a whole is learning, it’s important to reduce risky opioid-related prescribing,” explained first author Lewei Allison Lin, MD, an addiction fellow in the UM Department of Psychiatry who trained in the VA system. “We hope that these findings, showing the VA OSI was associated with a reduction in risky prescribing will encourage others to consider similar healthcare system interventions to address this complex issue.”