Opioid use down 40 percent as part of pilot program at Yampa Valley Medical Center
January 25, 2018
STEAMBOAT SPRINGS — UCHealth Yampa Valley Medical Center has spent the last six months working to reduce the amount of opioids it administers in its emergency department, and by making this mission a top priority, opioid use decreased by 40 percent.
"It's all part of that whole raising awareness of the risks and the benefits of every medication you take," said Wes Hunter, director of pharmacy at YVMC and president of the Colorado State Board of Pharmacy. "There is a legitimate pharmacologic purpose for opioids, but there are also risks to them."
YMMC was one of several emergency rooms across the state to participate in the six-month pilot program.
On Thursday, the results of the pilot program were revealed at the first-ever Colorado Opioid Safety Summit in Denver. It was reported that emergency departments involved with the program had a 36 percent drop in the amount of opioids used when compared to the same time period in 2016 . These results surpasses the program goal of a 15 percent reduction.
The drop ranged from a 31 percent reduction at one emergency department to 46 percent at another. In Steamboat, Hunter estimates the drop to be roughly 40 percent according to his data.
“The numbers mean that the emergency room clinicians are doing a great job of giving people other options rather than just providing these controlled substances as a first line of defense," said Mara Rhodes, regional coordinator for the RX Task Force for the Northwest Colorado Community Health Partnership. "By educating the patients and saying ‘look we have other options out there,’ I don't feel like they are doing the patient a disservice. I feel like they are providing the patient with opportunities to do less risky forms of treatment and symptom maintenance. It means less addictions moving forward, and it is an opportunity for people to remove their exposure to these medications."
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The pilot included eight hospitals and two freestanding emergency departments spread out across the state from rural areas like Steamboat Springs and Sedgwick County to large Front Range hospitals like Swedish Medical Center and UCHealth Poudre Valley Hospital.
The project was a collaboration between the Colorado Hospital Association and its partners. It was one of the largest opioid research efforts in the United States and used treatment guidelines developed by the Colorado Chapter of American College of Emergency Physicians, which recommends the use of alternatives to opioids for the treatment of pain.
The pilot facilities treated a combined total of 130,631 unique patients during the six-month pilot period including 4,164 in Steamboat. Hunter said all participating hospitals administered 35,000 fewer doses of opioids between the 2017 pilot and the 2016 baseline period. He said that was significant.
"There is really no way to put that genie back in the bottle," Hunter said. "Once physicians have a tool kit for treating pain in a safer method, there is no reason going to revert to anything else."
Hunter said the success of the program in Steamboat went well beyond the numbers to the relationships between caregivers and patients.
"The program gave our doctors a platform to sit down with a patient and talk about the advantages and disadvantages of all methods of treating their pain,” Hunter said. “It allowed them to do risk assessment of the patients and then talk with the patient about what the patient was willing to accept as far as risks, and what they are willing to try before we go down the road of opioids."
Hunter believes the program, combined with more awareness about opioids, is part of an important conversation.
"We have a number of patients that are coming into the hospital, or into the emergency room that state right out front, 'I would like to avoid opioids," Hunter said. "It's a sizable population that is doing that, and that is wonderful … that is the kind of success that the community can build on."
Ken Davis, with the Northwest Colorado Health Partnership, is also hoping the example set by the hospital is something that the community can build on in the future.
"I think if we took the lead of our hospital, and primary care practices or orthopedic offices or dentist practices could really evaluate our guidelines and protocols around prescribing, and instead of giving the 30 or 60 pills, they really made sure that people are only getting the minimum amount that they need to take care of their issue," Davis said. "We know with some very good data that if you are taking opioids more than three or seven days the likelihood of still being opioids six months or even years later dramatically increases.
“There is some really exciting things that are gong to come out of this work already demonstrated by the hospital ER," Davis added.
Now that the pilot program has concluded, the next step will be to roll out the program to emergency departments across the state.
"It's going to be a major undertaking, but I think it will be done well," Hunter said.