Jantzen, Aleesha

AbstractUsing pharmacy claims data from a single commercial health plan to identify opportunities for opioid use disorder (OUD) focused screening and interventions communicated via targeted prescriber messaging. Participants included members ≥18 years using more than 90 morphine milligram equivalents (MMED) daily based on all opioid claims, had >1 paid claim for an opioid product, and had ≥90 days of total opioid therapy. Members were excluded with ≥1 claims for an oral chemotherapy agent (except methotrexate). Intervention was completed with a secure communication to the primary outpatient opioid prescriber that included resources for diagnosis, treatment, and best practices for opioid prescribing. The main outcome measure was any documented change to opioid use following the intervention. Seven hundred forty‐five members were identified; a subset (n = 20) was further assessed, and all had identified OUD risk factors; providers were subsequently sent a communication. Sixteen providers acknowledged receipt and 11 patients (55%) had at least one documented intervention following communication receipt. Provision of targeted, evidence‐based recommendations to providers for patients identified to be at risk of OUD from pharmacy claims data can result in increased recognition and intervention. Future efforts to explore feasibility of provider education detailing efforts and continued evaluation of efficacy are needed.

Background: Recent literature demonstrated a 24-hour reduction in vancomycin duration of therapy (DOT) for skin and soft tissue infections (SSTIs) with a negative methicillin-resistant staphylococcus aureus (MRSA) nasal screening versus a positive nasal screening. Objective of this study was to investigate vancomycin DOT in patients with SSTIs who received MRSA nasal polymerase chain reaction (PCR) screening versus those who did not receive MRSA nasal PCR screening. Methods: A retrospective, multi-center, cohort study was completed in admitted adult patients on vancomycin for SSTI from 01/01/2020 to 09/30/2022. Hospital policy permits any clinician to order a MRSA nasal PCR screening test for various indications, including SSTIs, pneumonia and sepsis. Results: One-hundred-fifty-one patients were included, of which 71 had MRSA nasal PCR screening tests obtained, and 80 did not. The median vancomycin DOT in patients with MRSA nasal PCR screening tests was 19.9 versus 36.7 hours ( P = .014) in patients without screening tests. Conclusion: Patients with SSTIs who receive MRSA nasal PCR screening tests have a shortened vancomycin DOT. These results contribute to current data in support of the efficacy and clinical utility of obtaining MRSA nasal PCR screening tests for SSTIs.