Opioids: What do healthcare professionals want and need to know?

Editor’s note: The following is article first appeared in the April 2016 edition of PSQH, and was written by members of the National Patient Safety Foundation. Patricia McGaffigan, RN, MS is chief operating officer and senior vice president of programs, Caitlin Y. Lorincz, MS, MA is senior program director; and Tejal K. Gandhi, MD, MPH, CPPS is president and CEO.

The availability of, and access to effective and safe treatments for pain remain serious problems in the United States (Institute of Medicine, 2011). Opioid medications are important for addressing short-term and chronic pain management. Given the benefits that they provide, usage of opioids has become widespread over the past decade. However, opioid medications also carry substantial risk, and their increased usage has introduced a host of unintended consequences across the care continuum. Given this, opioids have significant implications for patient safety. The National Patient Safety Foundation (NPSF) conducted a convenience flash poll survey to obtain a snapshot of opioid-related patient safety concerns, learning needs, and familiarity with existing seminal publications among healthcare professionals.

The number of prescribed and dispensed opioids doubled between 1999 and 2010, according to the U.S. Department of Health and Human Services (HHS) as quoted in the National Action Plan for Adverse Drug Event Prevention (HHS ODPHP, 2014). In inpatient settings, a 2012 research database of 1,665,418 hospitalized patients showed that 72% of patients treated with IV analgesia received IV opioid monotherapy.1 In ambulatory care settings, research indicates that as many as 20% of patients with pain-related diagnoses or non-cancer pain symptoms (including chronic and acute pain) presenting to physician offices receive a prescription for an opioid medication (Daubresse et al., 2013). Further, a Joint Commission Sentinel Event Alert reports that “[o]f the opioid-related adverse drug events, including deaths, that occurred in hospitals and were reported to The Joint Commission’s Sentinel Event database (2004–2011), 47% were wrong-dose medication errors, 29% were related to improper monitoring of the patient, and 11% were related to other factors, including excessive dosing, medication interactions, and adverse drug reactions” (Joint Commission, 2012).

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