{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T05:00:24Z","timestamp":1767848424250,"version":"3.49.0"},"reference-count":22,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,7,14]],"date-time":"2017-07-14T00:00:00Z","timestamp":1499990400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Evaluation Clinical Practice"],"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Rationale, aims, and objectives<\/jats:title><jats:p>The United States is in the midst of a public health epidemic with more than 40 people dying each day from prescription opioid overdoses. Health care systems are taking steps to address the opioid overdose epidemic by implementing policy and practice interventions to mitigate the risks of long\u2010term opioid therapy. Kaiser Permanente Southern California launched a comprehensive initiative to transform the way that chronic pain is viewed and treated. Kaiser Permanente Southern California created prescribing and dispensing policies, monitoring and follow\u2010up processes, and clinical coordination through electronic health record integration. The purpose of this paper is to describe the implementation of these interventions and assess the impact of this set of interventions on opioid prescribing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>The study used a retrospective pre\u2010post evaluation design to track outcomes before and after the intervention. Kaiser Permanente Southern California members age 18 and older excluding cancer, hospice, and palliative care patients and this sub\u2010population of 3\u00a0203\u00a0880 was approximately 75% of all Kaiser Permanente Southern California members. All data are from Kaiser Permanente's pharmacy data systems and electronic health record collected on a rolling basis as interventions were implemented from January 2010 to December 2015.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were reductions in all tracked outcomes: a 30% reduction in prescribing opioids at high doses; a 98% reduction in the number of prescriptions with quantities greater than 200 pills; a 90% decrease in the combination of an opioid prescription with benzodiazepines and carisoprodol; a 72% reduction in the prescribing of Long Acting\/Extended Release opioids; and a 95% reduction in prescriptions of brand name opioid\u2010acetaminophen products. In addition, methadone prescribing did not increase during this period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study adds promising results that a comprehensive system\u2010level strategy has the ability to positively affect opioid prescribing. The basic components of the intervention are generalizable and applicable to other health care settings.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jep.12756","type":"journal-article","created":{"date-parts":[[2017,7,14]],"date-time":"2017-07-14T08:02:51Z","timestamp":1500019371000},"page":"1173-1179","source":"Crossref","is-referenced-by-count":56,"title":["Safer and more appropriate opioid prescribing: a large healthcare system's comprehensive approach"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6875-0746","authenticated-orcid":false,"given":"Jan L.","family":"Losby","sequence":"first","affiliation":[{"name":"Division of Unintentional Injury Prevention Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joel D.","family":"Hyatt","sequence":"additional","affiliation":[{"name":"Community Health Improvement, Southern California Permanente Medical Group SCPMG Regional Administration  Pasadena California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael H.","family":"Kanter","sequence":"additional","affiliation":[{"name":"Southern California Permanente Medical Group SCPMG Regional Administration  Pasadena California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grant","family":"Baldwin","sequence":"additional","affiliation":[{"name":"Division of Unintentional Injury Prevention Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denis","family":"Matsuoka","sequence":"additional","affiliation":[{"name":"Drug Use Management Southern California Kaiser Permanente  Downey California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,7,14]]},"reference":[{"key":"e_1_2_7_2_1","volume-title":"Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research","author":"Institute of Medicine","year":"2011"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e3182a95d86"},{"key":"e_1_2_7_4_1","volume-title":"Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings","author":"Substance Abuse and Mental Health Services Administration","year":"2014"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm655051e1"},{"issue":"43","key":"e_1_2_7_6_1","first-page":"1487","article-title":"Vital signs: overdoses of prescription opioid pain relievers \u2013 United States, 1999\u20102008","volume":"60","author":"Paulozzi LJ","year":"2011","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.370"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-152-2-201001190-00006"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2011.117"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/pme.12480"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2014.10.001"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2016.0448"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2016.07.003"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2015.12.025"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4637.2011.01126.x"},{"key":"e_1_2_7_16_1","first-page":"1","article-title":"CDC guideline for prescribing opioids for chronic pain \u2014 United States","volume":"65","author":"Dowell D","year":"2016","journal-title":"MMWR"},{"key":"e_1_2_7_17_1","unstructured":"Centers for Medicaid and Medicare.OMS users guide: Table a \u2010\u2010 opioid drug products opioid content and MED conversion factors. 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