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Promoting Patient-Centeredness in Opioid Deprescribing: a Blueprint for De-implementation Science.
Kertesz, Stefan G; McCullough, Megan B; Darnall, Beth D; Varley, Allyson L.
Afiliação
  • Kertesz SG; Birmingham VA Medical Center, Birmingham, AL, USA. skertesz@uabmc.edu.
  • McCullough MB; Division of Preventive Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA. skertesz@uabmc.edu.
  • Darnall BD; VA HSR&D Center for Healthcare Organization and Implementation Research, Boston, MA, USA.
  • Varley AL; Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA.
J Gen Intern Med ; 35(Suppl 3): 972-977, 2020 12.
Article em En | MEDLINE | ID: mdl-33145692
A downward trend in opioid prescribing between 2011 and 2018 has brought per-capita opioid prescriptions below the levels of 2006, the earliest year for which the Centers for Disease Control and Prevention has published data. That trend has affected roughly ten million patients who previously received long-term opioid therapy. Any effort to reduce or replace a prior health practice is termed de-implementation. We suggest that the evaluation of opioid prescribing de-implementation has been misdirected, within US policy and health research, resulting in detrimental impacts on patients, their families and clinicians. Policymakers and implementation scientists can address these deficiencies in how we study and how we perform opioid de-implementation by applying an implementation science framework: the Consolidated Framework for Implementation Research. The Consolidated Framework lays out relevant domains of activity (internal, external, etc.) that influence implementation processes and outcomes. It can deepen our understanding of how policies are chosen, communicated, and carried out. Policymakers and researchers who embrace this framework will need a better approach to measuring success and failure in health care where both pain and opioids are concerned. This would involve shifting from a reductive focus on opioid prescription counts toward measures that are more effective, holistic, and patient-centered.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Desprescrições / Analgésicos Opioides Tipo de estudo: Sysrev_observational_studies Limite: Humans País/Região como assunto: America do norte Idioma: En Revista: J Gen Intern Med Assunto da revista: MEDICINA INTERNA Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Desprescrições / Analgésicos Opioides Tipo de estudo: Sysrev_observational_studies Limite: Humans País/Região como assunto: America do norte Idioma: En Revista: J Gen Intern Med Assunto da revista: MEDICINA INTERNA Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Estados Unidos