Dissemination, Implementation, and Evaluation of CDC’s Guideline for Prescribing Opioids for Chronic Pain

Clinical practice prescribing guidelines hold promise for improving care to ensure the safer use of long-term opioid therapy for patients. CDC’s Guideline for Prescribing Opioids for Chronic Pain is intended to improve communication between providers and patients about the risks and benefits of opioid therapy for chronic pain, improve the safety and effectiveness of pain treatment, and reduce the risks associated with long-term opioid therapy, including opioid use disorder and overdose. Following the principles of the Interactive Systems Framework, CDC developed a comprehensive dissemination and implementation plan that distills information, builds capacity, and facilitates integration using the following strategies: (1) translation and communication of key messages by creating a suite of tools to clearly communicate the guideline recommendations to multiple stakeholders such as providers, patients, and the general public; (2) provider education and training to inform consistent messaging on opioid prescribing based on guideline recommendations across the educational/training continuum for key audiences, including medical/nursing/pharmacy school curricula, residency training, and continuing education requirements; (3) health systems integration strategies, such as quality measures and electronic health record (EHR) decision support, to foster implementation by administrators and providers within primary care; and (4) integration within private and public insurer benefit plans to foster implementation through proactive use of claims information and improvement in coverage and service delivery payment models. CDC has also developed a comprehensive evaluation strategy to document outputs (e.g., training modules, quality improvement measures), short-term outcomes (e.g., integration of recommendations into the EHR, increased provider knowledge), intermediate-term outcomes (e.g., reduction in opioid prescribing rate, increase in prescription drug monitoring program use), and long-term outcomes (e.g., non-fatal and fatal overdose).

Presenters describe the implementation strategies and the logic model for the evaluation. Outputs and short-term outcomes within the first year of implementation are described. For example, presenters will review metrics on downloads and use of translation materials, estimates of knowledge improvements and continuing medical education credits received, findings from pilot evaluations of health systems strategies, and results of partnership efforts with public and private insurers.