Dr Woody Eisenberg Explains PQA's New Opioid Measures

The new opioid measures from the Pharmacy Quality Alliance (PQA) are supposed to compare opioid dosages across organization to attempt to get a handle on the issue of opioid addiction, said Woody Eisenberg, MD, senior vice president of performance measurement and strategic alliances for the PQA.

Transcript (slightly modified)

What are the Pharmacy Quality Alliance’s new opioid measures and how were they developed?

The new opioid measures, we’re very excited about them. But let’s go back to why we developed them to begin with. Understand that patients in pain are in desperate need of relief of that pain. And in many cases that can be accomplished with medications that are less strong than opioids or narcotics, morphine being an example, but in some cases they really need to have the strongest pain medications, and the strongest pain medications are opioids, narcotics.

The downside of that, of course, is that opioids can be habit forming, people can develop tolerance to them, sometimes requiring increasing doses, and sometimes they can become addicted to these drugs. So for forever there has been this very delicate balance that patients and their caregivers have had to tread: When do you have enough of these medications so that you can relieve the pain enough so you can become comfortable and function? And when have you gone over and given someone perhaps too much medication so that it’s clouding their functioning and perhaps leading to worse problems than their original illness, which caused their pain. And this is a balance that has got to be decided for each and every patient.

So having said that, there are some guidelines about how to use the medications, which chronic conditions are most likely to benefit from the use of the medications. There’s also some guidance on the doses and the duration of use. And what we’ve tried to do at PQA is to use the various guidelines that are out there to determine dosages and numbers of prescribers and numbers of pharmacies where patients are getting these medications, not so much for each individual patient—because as I’ve said that’s a very individual determination that must go on for each individual patient—but our measures are intended to be applied across populations of patients.

So what we’re saying, for example, is that even though any given patient may have needs for high doses or these drugs for long periods of time or even for multiple prescribers, that over a large population we’re anticipating that this is something we can measure and try to determine what the factors are that are leading one health plan or one provider organization or one accountable care organization to be prescribing these medications for their patients at higher doses, for longer periods of time, by more prescribers and having them pick them up at more pharmacies than a comparable organization.

And we think that that comparison may help us to get a handle on this problem