• Natalia P Arizmendez, Fabiana Kotovicz, Jessica J F Kram, and Dennis J Baumgardner.
• From Aurora Health Care, Department of Family Medicine, Aurora St. Luke's Medical Center, Milwaukee, WI (NPA, FK, DJB); Aurora Health Care, Department of Internal Medicine, Aurora St. Luke's Medical Center, Milwaukee, WI (NPA); Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison (FK, JJFK, DJB); Aurora Health Care, Aurora UW Medical Group and Center for Urban Population Health, Aurora Sinai Medical Center, Milwaukee, WI (JJFK, DJB).
• J Am Board Fam Med. 2019 Jul 1; 32 (4): 559-566.

BackgroundOpioid misuse in the United States has made it challenging for physicians to treat chronic noncancer pain (CNCP). We implemented an educational program aimed at promoting safe opioid prescribing practices in hopes of increasing the level of appropriateness associated with prescribing opioids for CNCP.MethodsWe conducted a quality-improvement study with a retrospective chart review of adult patients who were prescribed opioids for CNCP for at least 90 consecutive days at 2 academic primary care clinics. Patients were reviewed at baseline (July 2014-May 2015) and after initial interventions (January 2016-June 2016; ie, following multimodal educational activities on appropriate opioid prescription implemented from June 2015-December 2015). An opioid appropriateness score was calculated based on documentation of 9 items. Categorical variables were analyzed with Fisher exact tests and continuous variables by 2-sample t tests and regression analysis. Binary logistic regression was used for multivariable modeling. Mann-Whitney test was used to compare appropriateness scores before and after intervention.ResultsA total of 177 and 96 patients were evaluated at baseline and postintervention, respectively. Patient demographic characteristics were not statistically different. Overall, postintervention level of appropriateness was significantly different from preintervention (P < .0001), with means increasing from 5.54 preintervention to 6.29 postintervention. Both clinics had significant improvement from baseline (both P values <.003).ConclusionsClinician education on best practices while treating CNCP is associated with an increase in the level of opioid use appropriateness.© Copyright 2019 by the American Board of Family Medicine.

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