LEXINGTON, Ky. (Nov. 13, 2018) – A new partnership between the University of Kentucky College of Public Health, the Kentucky Injury Prevention and Research Center (KIPRC), UK College of Pharmacy, the UK Institute for Pharmaceutical Outcomes and Policy and UK HealthCare will use data analytics for "Action Research to Reduce Opioid Supply and Demand." The work will be supported by a $1 million grant from the U.S. Department of Justice.
Svetla Slavova, associate professor of biostatistics in the UK College of Public Health; Douglas Oyler, an assistant professor in the UK College of Pharmacy and director of the UK HealthCare Office of Opioid Safety; Julia Costich, professor of health management and policy in the UK College of Public Health; and Dr. Phillip Chang, UK HealthCare chief medical officer and professor of surgery in the UK College of Medicine began working together earlier this year to identify data-driven interventions to reduce the risk of developing opioid dependence and addiction among inpatients discharged from UK HealthCare.
When a patient is treated at UK HealthCare in an inpatient setting they may be prescribed opioids. If they've had surgery, are being treated for cancer or a heart condition, an opioid prescription is not only the standard of care but treatment that relieves pain and enables many to return to day-to-day activities. However, when the patient has follow-up ambulatory appointments, the UK clinician who provided the initial assessment can lose track of opioid prescribing as other physicians and patient care providers become involved in care.
Slavova will lead the analytical work which will inform the design and implementation of interventions within UK HealthCare. The project will use data from the Kentucky All Schedule Prescription Electronic Reporting (KASPER) linked with UK HealthCare patient records. Slavova and her team will identify discharge diagnoses most often associated with high-dose or long-term opioid use after hospital discharge, with follow-up care done by non-UK physicians.
UK HealthCare will develop and pilot targeted interventions. A multidisciplinary team of UK HealthCare physicians including Drs. Phillip Chang, Lowell Anthony, Kristy Deep, Michael Harned, Michael Kindred and Lindsey Ragsdale will collaborate with additional specialists to develop diagnosis-specific educational materials to address opioid pain management options post-discharge, non-opioid pain management alternatives and information on safe opioid use, storage and disposal.
UK HealthCare will incorporate the developed educational materials into the standard inpatient discharge protocols. The UK analytical team will track and analyze the duration and dosage of opioid prescriptions filled by patients who received the training intervention at discharge as compared with a historical cohort. Additional interventions will focus on prescribers, providing specialty and sub-specialty groups with opportunities to discuss pressures they feel to prescribe and better ways to educate patients and other clinicians on the benefits and risks of taking opioids as well as strategies to reduce the risk of misuse, abuse and addiction.
As chief medical officer for UK HealthCare, Chang provided substantial support to Slavova and Oyler. UK HealthCare will leverage internal resources and implement prescriber and patient-oriented education and interventions informed by the analytical results produced by this project.
"When you get seasoned researchers and clinicians together in a room, you get great innovative projects like this," Chang said. "At an academic medical center like UK, there are many opportunities for those groups to work together."
UK HealthCare has the resources to conduct this kind of research, which if found to be successful Slavova, Oyler and Chang hope can be used by other facilities in Kentucky and across the nation.