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Six Building Blocks for Opioid Management


Highlights

  • To address the opioid epidemic, primary care must redesign chronic pain treatment.
  • An evidence-based approach can support redesigning care for these patients.
  • Abt is implementing and evaluating an opioid care management approach called the Six Building Blocks.
The Challenge

Primary care practices need to redesign the way they provide care to balance preventing opioid misuse and potential risks while addressing the needs of patients with chronic pain. The Agency for Healthcare Research and Quality (AHRQ) awarded Abt a contract to implement and evaluate the Six Building Blocks (6BBs) team approach to improve opioid management in primary care. The 6BBs represent six key work areas that primary care practices need to redesign to improve management of patients on chronic opioids.

The Approach

AHRQ funded Abt and partners to recruit a diverse set of primary care practices, develop a Clinic Implementation Guide for these practices to use to implement the 6BBs, and then evaluate practices’ implementation experiences and the effect of these changes on key outcomes. The 6BBs include: leadership and consensus; policies, patient agreements and workflows; tracking and monitoring patient care; planned, patient-centered visits; caring for complex patients; and measuring success.

The Results

Forty-two practices or clinics from 13 health care organizations have agreed to implement the Six Building Blocks using the Clinic Implementation Guide.  The guide was developed specifically for this project and is a step-by-step handbook clinics can use to adopt the 6BBs. Participating practices span ten states and include academic-affiliated clinics, federally qualified health centers, patient-centered medical homes, health-system or hospital-affiliated clinics, and private practices.

Related Resources:

Publications:

  • Parchman, M. L., Von Korff, M., Baldwin, L. M., Stephens, M., Ike, B., Cromp, D., ... & Wagner, E. H. (2017). Primary care clinic re-design for prescription opioid management. J Am Board Fam Med, 30(1), 44-51.
  • Parchman ML, Penfold RB, Ike B, Tauben D, Von Korff M, Stephens M, Stephens KA, Baldwin LB.  Team-based clinic redesign of opioid medication management in primary care: impact on opioid prescribing. Ann Fam Med 2019. (In Press)