title: Successful interventions in decreasing oxycodone CR prescriptions within an underserved population.
abstract: OBJECTIVE
  To use fundamental population health and Patient Centered Medical Home guidelines to create an effective intervention that would decrease the quantity of inappropriate oxycodone controlled release (CR) prescriptions within an uninsured population.
  
  
  METHODS
  This was a prospective interventional study.
  
  
  METHODS
  Patients seen in the newly formed University of Florida Community Health and Family Medicine Department Total Care Clinic, for chronic nonmalignant pain. This clinic was designed to serve the uninsured patients of Jacksonville, FL.
  
  
  METHODS
  A structured, step-wise pain management protocol was introduced and implemented, and an improved Controlled Substance User Agreement was created and implemented. Pharmacists and primary care providers collaborated on care.
  
  
  METHODS
  The primary study outcome measures were the number of oxycodone CR prescriptions over an 8-month period.
  
  
  RESULTS
  At the initiation of the program, the authors averaged over 40 oxycodone CR prescriptions per month. After 3 months, the number of prescriptions dropped to an average of 10 per month, a 75 percent decrease. More importantly, the number of oxycodone CR tablets saw a corresponding 75 percent drop from over 2,500 tablets per month to approximately 600 per month. Of course, the authors were concerned that the reduction of oxycodone CR may lead to increases in the use of other opioids. However, trends for hydrocodone/acetaminophen also showed a reduction in total usage as well as all other long-acting opioids. In addition, patient satisfaction did not change significantly, and no significant complaints from patients regarding this specific change were received.
  
  
  CONCLUSIONS
  By implementing criteria for oxycodone CR prescribing in an innovative, comprehensive, and unified patient-centered practice model, the authors saw a significant decrease in the number of oxycodone CR tablets prescribed per month and also a decrease in total prescriptions per month.
authors.affiliation: Community Health and Family Medicine, University of Florida, Jacksonville, Florida.
authors.forename: Nipa R
authors.initials: NR
authors.lastname: Shah
authors.affiliation: Community Health and Family Medicine, University of Florida, Jacksonville, Florida.
authors.forename: Judella
authors.initials: J
authors.lastname: Haddad-Lacle
authors.affiliation: University of Florida, Jacksonville, Florida.
authors.forename: Thanh
authors.initials: T
authors.lastname: Hogan
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage*; D003692:Delayed-Action Preparations; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D006801:Humans; D010098:Oxycodone / Q000008:administration & dosage*; D011446:Prospective Studies
chemical_list: D000701:Analgesics, Opioid; D003692:Delayed-Action Preparations; D010098:Oxycodone