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Virginia Hospitals Develop New Prescribing Guidelines to Combat Opioid Abuse
Guidelines Developed in Response to Emerging Community Challenges Associated with Prescription Opioid Misuse that has Claimed Thousands of Lives
RICHMOND, VA – A Task Force established to examine ways to reduce opioid abuse, particularly related to emergency room prescribing practices, has developed a set of recommendations to help guide hospital emergency departments in an era when prescription drug misuse has become more prevalent. The Task Force was created by action of the Virginia Hospital & Healthcare Association’s (VHHA) Board of Directors in January 2016. Work over the next several months by representatives from VHHA-member organizations and the Virginia College of Emergency Physicians produced 14 recommendations for setting general standards on opioid prescribing in Virginia hospitals’ emergency departments, which in 2014 had nearly 3.6 million patient visits.
The recommendations address specific instances in which emergency department (ED) personnel should exercise caution in prescribing opioids for treating chronic pain. They advise prescribers to dispense medications for the shortest time possible. They encourage greater communication between ED prescribers and patients’ primary care physician. They discourage the practice of providing replacement prescriptions, and advise caution when dispensing medication to patients without photo identification. They encourage providers to consult the Prescription Monitoring Database before making opioid prescriptions. They discourage the prescription of long-acting and controlled release opioids. And they encourage hospitals and ED providers to use clinical judgment regarding prescription decisions and care coordination to help patients appropriately and safely manage pain.
“Virginia’s hospitals, health care community, law enforcement apparatus, and elected leaders all recognize the importance of working to ensure that medications prescribed to patients are taken as intended, not misused,” said James B. Cole, President and CEO of Virginia Hospital Center and Chairman of VHHA’s Board of Directors. “Combating improper use of prescription medications is not a new effort by Virginia’s local hospitals and health systems. That has long been a consistent focus of health care providers. Given the current climate, VHHA’s members felt it appropriate to redouble those efforts on behalf of the patients and communities we serve, and the entire Commonwealth.”
The Task Force recommendations arrive at a time when considerable attention is focused on opioid use in this country. The U.S. Centers for Disease Control and Prevention (CDC) recently released a set of guidelines for prescribing opioids for chronic pain. Opioids are commonly prescribed as pain medication. Common types include codeine, fentanyl, hydrocodone, hydrocodone/acetaminophen, hydromorphone, meperidine, methadone, morphine , oxycodone, oxycodone and acetaminophen, and oxycodone and naloxone. The CDC estimates that 20 percent of patients who visit physician offices with non-cancer pain symptoms or pain-related diagnoses receive an opioid prescription. In Virginia, state and local law officials have engaged on this issue. During the 2016 General Assembly session, legislation intended to combat prescription drug misuse won bi-partisan approval.
“VHHA’s members are dedicated to the well-being of Virginia and Virginians,” said VHHA President and CEO Sean T. Connaughton. “Achieving that takes many forms: treating ailing patients and educating the community about healthy behaviors, supporting the economy through jobs and investment, clinical research to combat illness, and proactive steps to respond to community health challenges as they arise. That approach is reflected in the decision by Virginia’s hospitals to establish a Task Force to address prescription opioid misuse and the recommendations that effort has produced.”
Representatives from the following hospitals, health systems, and organizations were among those who made vital contributions to the Task Force in developing the recommendations: Augusta Health, Carilion Clinic, Clinch Valley Medical Center (LifePoint Health), HCA Virginia Health System, Inova Health System (Virginia Emergency Medicine Associates), Johnston Memorial Hospital (Mountain States Health Alliance), Sentara Healthcare (Sentara Albemarle Medical Center, Sentara Medical Group, Sentara Princess Anne Hospital, VCU Health (VCU Community Memorial Hospital, VCU Medical Center), Virginia College of Emergency Physicians, and Virginia Hospital Center.
About VHHA: The Virginia Hospital & Healthcare Association is an alliance of 107 hospitals and 30 health delivery systems that develops and advocates for sound health care policy in the Commonwealth. Its vision is to achieve excellence in both health care and health.