Empowering doctors to fight opioid crisis through best practices


ANDREW KOLODNY, MD:
The reason so many Americans
have become opioid addicted has a lot to do with the way
the medical community has been prescribing
opioid pain medicines. Trying to get the medical community
to prescribe opioids more cautiously, and trying to get
the medical community more engaged in treating opioid addiction
is essential for tackling the epidemic. DANIEL KNECHT, MD: Aetna is working
to educate our providers on appropriate prescribing
of opioids for chronic pain as well as screening and treating
Aetna members struggling with opioid use disorder. This program is addressing
two large, unmet health needs. Number one is how to
appropriately treat chronic pain using evidence-based guidelines. For some people
with painful conditions, nonpharmacologic approaches
like physical therapy can be very helpful. And for some people
with chronic pain conditions, there are medicines we can prescribe
that are safer and more effective than opioids. The other, is how do you screen and treat
people struggling with opioid addiction? A key component in this program
is really equipping those physicians to understand the difference
between true pain and those that are treating
their need for an opioid. – Very nice to meet you.
– It’s nice to meet you. – Please, have a seat.
– Thank you! DANIEL KNECHT, MD:
We’re deploying clinicians armed
with guidelines and evidence directly to the provider’s office. When we ask patients… PAUL FANIKOS, RPH:
An academic detailing session
is a one on one planned meeting with a practitioner
where evidence is shared. Specifically, if people have cravings,
if they’re always thinking about opioids… PAUL FANIKOS, RPH: Physicians
just generally don’t have the time to review and research the topic
to great depth. I have a couple of patients who
are probably on the border of that. PAUL FANIKOS, RPH: Academic
detailing does that for them. It packages the information in
a way that’s consumable for them, and then it’s delivered
interactively right in their office. So it sounds like your biggest concern
would be patients who have chronic pain. ELISABETH FOWLIE MOCK, MD:
One-on-one education delivered
in person, that’s custom tailored to someone, is much more likely to change behavior than forcing someone to sit in a large
classroom and look at PowerPoint slides. SCOTT SEYMOUR:
The key point is that we’re there to help. It’s not to be another thing
feeling like it’s intrusive – is that we’re really in it together. The practitioners are looking
for more than just being told that something’s wrong.
They also want a potential solution, and the best way is to address some
of these issues that patients face. If it’s interfering with their functioning –
so social problems, recreational problems… ELISABETH FOWLIE MOCK, MD:
We incorporate stories and data together, because the stories move us
in our heart and in our emotions, but the data help us to really practice sound
evidence-based prescribing habits. SCOTT SEYMOUR:
We encourage providers to take education,
learn about the opioid crisis, looking at their own data
and prescribing factors. Maybe they don’t realize that
they themselves are an outlier and contributing to it. DANIEL KNECHT, MD:
We have experts from the CDC,
National Institutes on Drug Abuse, Harvard, Johns Hopkins
picking the best clinical evidence and putting it together. ANDREW KOLODNY, MD:
Health insurance companies – like Aetna – are really on the frontline
of the opioid crisis, and can play a critically important role
in addressing the problem. The models are changing to allow us to
spend more time on those patients that need it and it also has
an infrastructure support to it. So, part of the reimbursement
and the value-based contracting is to help providers shift from a
fee-for-service mentality to an outcome-based. On the third page, we have
a little bit of information about the different medications we
can use to treat opioid use disorder. ERIN MCKENNA, PHARMD:
We’d like to see reductions
in the number of members using opioids with other potentiator drugs. We’d like to see reduced ER visits
for accidental overdose, and patients living healthier lives. And then the fourth and maybe
most important page is here about prescribing Naloxone. ERIN MCKENNA, PHARMD:
With this program, we have
the ability to target the prescriber who can change their practice
to the new treatment guidelines. By changing the prescriber,
we can change the lives of many members.

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