Safe Use of Opioids - Concurrent Prescribing

Jul 4, 2023

Introduction

This project monitors a healthcare system’s compliance with the Safe Use of Opioids, a clinical quality measure (eCQM) developed by CMS. The goal of the Safe Use of Opioids eCQM is to identify patients who are either prescribed or continue to take two or more opioids, or a combination of an opioid and a benzodiazepine, concurrently at the time of hospital discharge. This tracking will help develop strategies to reduce the risk of fatal overdoses associated with the concurrent use of these medications.


Methods

Using MIMIIC 3 Clinical database as source, the cohort includes patients;

  • Aged 18 and above at admission.
  • Admitted for more than 120 days
  • Admitted and discharged during the same year.
  • Opioids or benzodiazepine use during hospitalization.
  • Active opioids or benzodiazepine prescriptions at discharge.

The process measures tracked includes:

  • Average number of active opioids prescriptions at discharge ( XMR chart)
  • Average number of active benzodiazepine prescriptions at discharge (XMR Chart)
  • Percentage of Patients with active concurrent opioids and benzodiazepine prescriptions at discharge (P Chart)

The outcome measures tracked includes:

  • Readmission rate within 30 days of discharge (P Chart)

Results
  • 67% of patients were discharged with multiple prescriptions of opioids OR a combination opioid and benzodiazepine.
  • Patients were discharge with an average of 4 active opioids prescriptions.
  • Patients were discharge with an average of 2 active benzodiazepine prescriptions.
  • About 6% of patients were readmitted within 30 days.

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