Projects are designed and being implemented by a collaborative group with expertise in various aspects of pain, opioids, addiction, mental health and public policy.
Analysis of Administrative Data
Hospital records are being analyzed to characterize the population of opiate-using pain patients seen in Harborview Medical Center primary care clinics and currently enrolled in the Hareborview Medical Center's "pain registry". The "pain registry" contains a careful record of these patients' prescription opiate use and clinical status. Through this analysis, we are attempting to get a better understanding of the extent of the problem using several definitions of problem opiate doses as well as characteristics of this population, including service utilization patterns. This project is being headed up by Jeanne Sears PhD, an administrative data expert and health services researcher at CHAMMP.
Pain Tracker
Pilot funding of the "Pain Tracker", a physician decision support device, that is being made available on the web for use by Harborview Medical Center primary care physicians prescribing opiates in both Adult Medicine and Family Medicine Clinics. This project aims to improve the ability of the prescribing physician to appropriately prescribe opioids and to avoid inappropriate dose escalation and/or indefinite long-term prescription of opioids when these medications are not having beneficial effects on function and health status. It allows providers to monitor prospectively patients' pain, opiate type and dose, depression, anxiety and functional impairment. It is being headed up by Mark Sullivan MD, a national expert in opiate use and pain, and Jennifer Braden MD, a fellow working with Dr. Sullivan.
Opiate Registry Survey
We have begun to carry out an in-depth interview study of HMC opiate registry patients on long-term opioid therapy to gain a rich understanding of their characteristics beyond diagnostic codes and service use. In particular, we are gathering information on prior addictions and mental health histories, personality characteristics, availability of psychosocial supports, presence of severe ongoing chronic stressors, and personal coping and emotion-regulation styles. This information will be used to develop a multi-modal intervention that will include both pharmacotherapy (targeting both addiction and mental disorder) and behavioral treatment (targeting pain, coping and emotion regulation).
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