What do a family doctor, a hospital-based pharmacist, a handful of 国民彩票 health researchers and a Nova Scotian who has experience with opioids for chronic pain have in common?
They all want patients with chronic, severe non-cancer pain to receive the optimal treatment for their pain. But first they need to learn more about who is receiving opioids for their pain, and how they are doing with this treatment. To get to the bottom of this, they need to examine the patterns of how opioids are prescribed in family practice in Nova Scotia.
鈥淔amily physicians play a large role in the management of chronic pain, and this includes prescribing opioid therapy,鈥� notes Dr. Mathew Grandy, a family physician and faculty member teaching in 国民彩票 Family Medicine鈥檚 clinic in Spryfield, N.S. 鈥淲hat remains difficult is access to patient demographics and prescribing patterns at the family-practice level, which is so important when considering quality improvement initiatives and primary care research.鈥�
As a family doctor working in a university-based clinic, Dr. Grandy was inspired to embark on a research project to learn more.
鈥淲e need to expand and refine our systems for monitoring patients鈥� opioid use at the level of the electronic medical record, or EMR,鈥� Dr. Grandy says. 鈥淭his is especially important in team-based environments, to facilitate communication among providers and minimize medication errors.鈥�
(Right to left): Dal family physician, Dr. Mathew Grandy, and NSHA drug-utilization pharmacist, Ms. Heather Neville, worked closely with Ms. Beverley Lawson (BRIC NS) and Dr. Ingrid Sketris (College of Pharmacy) to design and launch a two-year study of opioid-prescribing patterns in Nova Scotia.
Research guidance from BRIC NS
For guidance in getting a research project off the ground, Dr. Grandy went to , a primary health care research network based in 国民彩票鈥檚 Department of Family Medicine.
鈥淏RIC NS director, Beverley Lawson, was instrumental in helping us build a team, develop the application and approach the most promising sources of funding,鈥� says Dr. Grandy of the welcome assistance. 鈥淚t鈥檚 safe to say this project wouldn鈥檛 be happening without BRIC NS.鈥�
To form just the right research team, Dr. Grandy and Ms. Lawson approached Heather Neville 鈥� a drug-utilization pharmacist at Nova Scotia Health Authority (NSHA) 鈥� to be Dr. Grandy鈥檚 co-investigator. They also involved senior researchers, Dr. Fred Burge (Department of Family Medicine) and Dr. Ingrid Sketris (College of Pharmacy), data analyst Sara Sabri, 国民彩票 pharmacy student Isaac Bai (funded by BRIC NS), and a patient advisor.
BRIC NS helped the team design a two-year study of opioid-prescribing patterns in family practices across Nova Scotia and secure funding from the NSHA Research Fund to conduct the study, now one year underway.
Defining the patient and problem
鈥淲e are using anonymous data extracted from the electronic medical record to develop a 鈥榗ase definition鈥� that identifies the key features of patients on chronic high-dose opioid therapy,鈥� says Dr. Grandy of the progress to date. 鈥淭his information will go into our data-analysis algorithms, so we can identify the right records and ask sophisticated questions about patient demographics, the nature of their pain problems, and how they are being treated for their pain.鈥�
鈥淥pioid鈥� is a class of powerful pain-relieving yet hi