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- Inpatient suicide
- Specialty Hospitals
Journal Article > Study
Development and applications of the Veterans Health Administration's Stratification Tool for Opioid Risk Mitigation (STORM) to improve opioid safety and prevent overdose and suicide.
Oliva EM, Bowe T, Tavakoli S, et al. Psychol Serv. 2017;14:34-49.
Opioid-related harm is an urgent patient safety priority. Identifying patients at higher risk of harm is a critical aspect of opioid safety. This quality improvement team developed a predictive model, based on electronic health record data, to identify high-risk opioid users in order to provide targeted monitoring and intervention via a clinical decision support tool. The model included known risk factors for opioid-related harm, such as type of medication, dose, and coprescribed sedating medications as well as medical and mental health conditions. Investigators developed and validated the model using data from 2010 and tested its ability to predict overdose or suicide attempt in 2011. The model successfully and prospectively identified patients at risk for suicide attempt or overdose. They then used the electronic health record to provide physicians with an overdose or suicide risk estimate and a checklist of risk mitigation strategies at the point of care. The authors suggest that further study of the implementation of this risk mitigation strategy in primary care is needed.
Journal Article > Study
Healthcare system-wide implementation of opioid-safety guideline recommendations: the case of urine drug screening and opioid-patient suicide- and overdose-related events in the Veterans Health Administration.
Brennan PL, Del Re AC, Henderson PT, Trafton JA. Transl Behav Med. 2016;6:605-612.
Opioids are considered high-risk medications and overdoses are common. Guidelines have been developed to facilitate safe prescribing practices. This study across 141 facilities within the Department of Veterans Affairs (VA) health system demonstrated that as adherence to urine drug screening guidelines increased from 2010 to 2013, the risk of suicide and overdose events among VA patients receiving prescription opioids decreased over the same period. The authors conclude that opioid therapy guidelines may have a positive impact on patient safety.