Radiologists can help drop unnecessary opioid prescriptions with low-cost imaging reporting change
Radiologists can help drop unnecessary opioid prescriptions with a low-cost reporting change, according to a new analysis published Thursday in the Journal of the American College of Radiology.
Patients often visit their provider for lower back pain, with imaging revealing no acute injury and only common signs of wear and tear. West Coast providers have experimented with inserting simple information into spine radiology reports detailing how others of the same age have seen similar scan results, with no need for pain pills.
The intervention has proven effective at dropping opioid prescriptions, with only a small implementation cost of roughly $5,000, depending on the institution. Experts encouraged others to explore making this change, even if it did not have a direct impact on their primary goal of reducing imaging usage.
“Systematically adding age-based prevalence information on imaging reports would require a low level of resources, including a small amount of personnel time for an IT programmer, a manager, and a radiologist,” lead author Brian Bresnahan, PhD, with the Seattle-based University of Washington’s Department of Radiology, and co-authors wrote June 30.
UW experts first explored the effectiveness of the Lumbar Imaging With Reporting of Epidemiology intervention in JAMA Network Open last year. The randomized clinical trial incorporated some 239,000 patients treated between 2013-2016 who received spine imaging at one of 98 primary care clinics tied to four large health systems. Wednesday’s follow-up dived into the costs required for LIRE, as they call it for short.
Bresnahan et al. calculated time and cost commitments, noting that implementation would require radiologists and primary care docs, IT specialists and a project manager. They estimated a total average cost of implementing LIRE at $5,000 (with a range anywhere from $2,600 to $12,000), which included pilot-testing with providers. Roughly 75% of such costs were made up by small amounts of time from a radiologist (6-12 hours) and imaging ordering providers (1-8 hours apiece). Implementation took roughly 1-2 days of effort by a radiology IT specialist, with variability depending on the number of clinics, level of experience in imaging departments, and interconnectivity between sites.
“The LIRE intervention seems to be a relatively low-resource-intensive, evidence-based tool that can be quickly and easily integrated into the reporting of spine imaging,” the authors advised, adding that the program could serve as an example for other imaging indications to help with decision support.
You can read the rest of the study in JACR here.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.