Care transitions after trauma hospitalization can be associated with miscommunication or incomplete transfer of information, which has the potential to lead to unintentional persistent opioid prescribing or other deficiencies in post-trauma pain care. Decreasing exposure to prescription opioids is critical to lowering risk of opioid misuse, overdose and opioid use disorder.
In a new study published January 2023 in Trauma Surgery & Acute Care Open (TSACO), a level I trauma center successfully implemented an opioid taper support program directed to the primary care providers (PCPs) of patients discharged from a level I trauma center to their homes distant from the center, though only 51% of the discharged patients had a confirmed PCP. Most program consultations were with medical assistants or nurses (78%) rather than PCPs (22%), and these consultations identified that patients and PCPs need a clear taper plan and information on who is responsible for post-trauma care and opioid management after discharge.
The critical need to improve the care transition from inpatient hospitalization to community for patients discharged after trauma will need a more robust care coordination intervention than that provided in this study, perhaps including both patient-level and provider-level interventions as well as specific payment mechanisms.
Authors on this publication represent: the Department of Family Medicine, Harborview Injury Prevention & Research Center, Department of Anesthesiology & Pain Medicine, Department of Psychiatry & Behavioral Sciences, Department of Medicine, and Department of Surgery at the University of Washington School of Medicine.