Opioid Therapy: Follow-up Evaluation

ACP does not support QPP measure 408: "Opioid Therapy Follow-Up and Evaluation. This is a “check the box measure.” Adherence to a follow-up evaluation program does not necessarily improve quality outcomes. A more appropriate measure may incentivize a standardized, methodological approach to evaluation that is likely to improve the opioid therapy management process and result in improved clinical outcomes. While implementation could prevent overuse of opioid therapy, there is insufficient evidence to support the 6 weeks and 3 months durations included in the denominator and numerator specifications. While the measure aligns with Centers for Disease Control and Prevention recommendations on prescribing opioids for chronic pain, we suggest the developers revise the specifications to include an evidence based-definition of chronic opioid therapy. Furthermore, it is unclear whether clinicians who prescribe therapy for less than 3 months should require patient followup earlier than 3 months’ time. The measure would benefit from reliability and validity testing prior to implementation and inclusion in quality payment programs.