Category: Federal Forum Posters
Purpose: Currently, sublingual buprenorphine containing products are prescribed off-label by certain providers for managing chronic pain. However, limited information is available regarding recommendations on prescribing. What specific patient characteristics to be considered prior to initiation or discontinuation of buprenorphine treatment or factors that may affect clinical outcomes have not been well established. The purpose of this quality improvement project (QI) is to assist in patient care by determining the efficacy and safety of sublingual buprenorphine in a Veteran population, with subsequent provider education on the efficacy and safety of these agents and to characterize patient factors involved in trends of continuation.
Methods: The Institutional Review Board (IRB), University of Nevada, Reno reviewed the project and determined it as a non-research QI activity. Veterans prescribed sublingual buprenorphine for chronic pain between March 1, 2018 and September 21, 2018 will be assessed through retrospective and prospective data collection. Veterans will be identified using a preexisting dashboard. Retrospective chart reviews will allow collection of data on factors believed to contribute to continuation or discontinuation of buprenorphine. Veterans currently on treatment will also be contacted via telephone to collect further information regarding sublingual buprenorphine, including home induction experience, quality of life and perception of pain after buprenorphine initiation, adverse reactions, and functionality. Collected data will be tabulated illustrating Veteran factors, quality of life, pain assessment, adverse reactions, and functionality. The data will be divided between Veterans who continued sublingual buprenorphine and those who did not. Trends in patient factors amongst these two groups will be identified and compared.
Results: Expected results will be the identification of trends and Veteran specific factors that led to continuation or discontinuation of sublingual buprenorphine, as well as identification of risks versus benefits with buprenorphine use in managing chronic pain in a Veteran population. This may expand health care provider education and knowledge on prescribing sublingual buprenorphine for chronic pain and decrease in the number of discontinuations or failures of treatment.
Conclusion: Results will be presented at the Western States Conference in San Diego, CA in May of 2019.
Chanese Hampton– PGY1 General Pharmacy Resident, VA Sierra Nevada Health Care System, Reno, NV