Identifying the enablers to good opioid stewardship

Con­sis­tent with inter­na­tion­al trends, rates of opi­oid pre­scrib­ing con­tin­ue to increase across the nation. Opi­oids are high risk med­i­cines and opi­oid-relat­ed harm is well known. Enhanc­ing opi­oid stew­ard­ship requires the abil­i­ty to share exper­tise, knowl­edge and data across the health system.

In late 2021, the Statewide Chron­ic Pain Clin­i­cal Net­work host­ed an Opi­oid Round­table to dis­cuss how opi­oids are cur­rent­ly used to man­age pain and con­sid­er what could be done to ensure they are used as safe­ly and effec­tive­ly as possible.

The round­table told us that good opi­oid stew­ard­ship con­sists of:

• Active col­lab­o­ra­tion across all aspects of the health sec­tor to deliv­er a coor­di­nat­ed approach to plan­ning and follow-up.
• Safe pre­scrip­tion of med­ica­tion that is sup­port­ed by robust dis­charge plan­ning and high-qual­i­ty edu­ca­tion for clin­i­cians, con­sumers and the community.
• Nor­mal­is­ing pain and set­ting appro­pri­ate treat­ment expec­ta­tions which are then sup­port­ed by time­ly access to alter­na­tive ser­vices and a per­son­alised ​‘Whole Pack­age of Care’ includ­ing psy­cho­log­i­cal and phys­i­cal therapies.
• Opti­mis­ing elec­tron­ic sys­tems and data access to improve prac­tice and patient outcomes.
• Bal­anc­ing the ten­sion between deci­sion sup­port and oversight.
• An evi­dence informed Statewide Framework/​Pain Man­age­ment Plan.

Par­tic­i­pants also dis­cussed how we would mea­sure suc­cess and sug­gest­ed the fol­low­ing next steps:

• Estab­lish a work­ing group as a col­lab­o­ra­tion between the Statewide Chron­ic Pain Clin­i­cal Net­work and the Chief Phar­ma­cist to inform rep­re­sen­ta­tion to the Statewide Clin­i­cal Gov­er­nance Strate­gic Group.
• Explore dri­vers that can enhance the posi­tion of pain man­age­ment as a key pri­or­i­ty. The pri­ma­ry areas that were iden­ti­fied for this work included:

Fol­low­ing the Round­table, the Statewide Chron­ic Pain Clin­i­cal Net­work and the Office of the Chief Phar­ma­cist have estab­lished a col­lab­o­ra­tion and will bring togeth­er the sug­gest­ed work­ing group to over­see work to improve opi­oid stewardship.

Scop­ing work has also com­menced to improve the tran­si­tion between acute and non-acute ser­vices to ensure peo­ple receive care in the most appro­pri­ate setting.

A small work­ing group led by the clin­i­cal infor­mat­ics team at CEIH is also review­ing poten­tial data sources to analyse the top five opi­oid-relat­ed impacts on the health sys­tem, as iden­ti­fied by the roundtable.

To read about more about the Net­work and its projects, see Statewide Chron­ic Pain Clin­i­cal Network.