ProMedica's Prescribing Alternatives Instead of Narcotics (PAIN) project will be implemented in Lucas County, Ohio at ProMedica Toledo Hospital (PTH) and Flower Hospital (PFH) emergency departments (EDs). PAIN will target adults presenting at the EDs with acute headache/migraine, acute or chronic back pain, dental pain, renal colic, and extremity fractures/sprains, which are the most common pain-related conditions being treated at PTH and PFH EDs.
PAIN expands upon the successful Alternatives to Opioids (ALTO) project conducted at the St. Joseph's Healthcare System in Patterson, New Jersey. With the focus on improving pain management, patient care, and patient safety, the ALTO program utilizes targeted non-opioid medications and strategies to reduce the patient's pain, avoiding opioid use whenever possible. After only three months of focusing on acute lower back pain, renal colic, and headache, St. Joseph's ALTO program had incredible success, reducing the need for opioid pain management by 47.6%. PAIN will also integrate non-pharmacological pain reduction interventions, such as complementary/alternative therapies, physical interventions, and psychosocial interventions. Numerous studies have demonstrated that the most effective treatments in chronic pain consists of combining non-pharmacologic interventions with pharmacological treatments. PAIN addresses the full breadth of pain in the ED by combining an on-site pain management specialist in the ED with unique treatment modalities along with fully integrated warm handoffs for medication assisted treatment (MAT).
It is estimated that the number of individuals to be served through the PAIN program will be 8,000 over the three-year project period (2000 Y1, 3,000 Y2, 3,000 Y3). The goal of PAIN is to develop and implement an alternatives to opioids for pain management program at PTH and PFH EDs. There are three objectives to achieve this goal: Objective 1: By August 31, 2023, PAIN will reduce the number of opioids given to patients presenting to the PTH/PFH EDs with acute headache/migraine, acute or chronic back pain, dental pain, renal colic and extremity fractures/sprains by 45%. Objective 2: By August 31, 2023, PAIN will increase the percentage of patients in PTH/PFH EDs being offered the use of non-pharmacologic approaches for pain management for acute headache/migraine, acute or chronic back pain, dental pain, renal colic, and extremity fractures/sprains from 0 to 20%. Objective 3: By August 31, 2023, PAIN will offer MAT and subsequent referral/warm handoff for ongoing treatment to 90% of eligible patients who present to the PTH/PFH EDs with a SUD.