Agency Information Collection Activities: Proposed Collection; Request
| Published date | 24 April 2020 |
| Citation | 85 FR 23029 |
| Record Number | 2020-08727 |
| Section | Notices |
| Court | Agency For Healthcare Research And Quality,Health And Human Services Department |
Federal Register, Volume 85 Issue 80 (Friday, April 24, 2020)
[Federal Register Volume 85, Number 80 (Friday, April 24, 2020)]
[Notices]
[Pages 23029-23030]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2020-08727]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Agency for Healthcare Research and Quality
Agency Information Collection Activities: Proposed Collection;
Request
AGENCY: Agency for Healthcare Research and Quality (AHRQ), Department
of Health and Human Services (HHS).
ACTION: Request for Information; notice of extension of comment period.
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SUMMARY: For the ``Opioid Management in Older Adults'' project, AHRQ is
seeking to identify innovative approaches to managing opioid
medications for chronic pain that are particularly relevant for older
adults. Use of long-term opioid therapy in older adults can be
especially problematic because of increased risks such as delirium,
falls, and dementia. Through this notice, the comment period has been
extended to June 30, 2020. The subject matter content remains unchanged
from the original notice which was previously published on March 18,
2020 (https://www.govinfo.gov/content/pkg/FR-2020-03-18/pdf/2020-05612.pdf).
[[Page 23030]]
DATES: Information must be received by June 30, 2020.
ADDRESSES: Written comments should be submitted by email to:
[email protected].
FOR FURTHER INFORMATION CONTACT: Parivash Nourjah,
[email protected], or 301-427-1106.
SUPPLEMENTARY INFORMATION:
The United States is in the midst of an unprecedented opioid
epidemic that is affecting people from all walks of life. Regulators
and policy makers have initiated many activities to curb the epidemic,
but relatively little attention has been paid to the growing toll of
opioid use, opioid misuse and opioid use disorder (OUD) among older
adults.
The opioid crisis in older adults is strongly related to challenges
in prescription opioid management in this population. Older adults have
a high prevalence of chronic pain and are especially vulnerable to
suffering adverse events from opioid use, making safe prescribing more
challenging even when opioids are an appropriate therapeutic choice.
Identifying adverse effects due to opioid use, misuse or abuse is
complicated further by factors such as co-occurring medical disorders
that can mimic the effects of opioid use. There is also a risk of
attributing clinical findings in older adults (e.g. personality
changes, falls/balance problems, difficulty sleeping, and heart
problems) to other conditions that are also common with age. If adverse
events due to opioid prescriptions are identified, finding appropriate
alternatives for pain management can be challenging if other
pharmacologic options (such as NSAIDS) are contraindicated or mobility
issues limit access to other therapeutic options.
Diagnosis of substance use disorders is also more complicated in
this population. Clinicians may not associate drug misuse or addiction
with older adults or they may be inadequately trained in identification
and treatment of opioid misuse and OUD among older adults, and hence
may not monitor for the signs of opioid use disorder in this
population.
Successfully optimizing the prescribing and use of opioids in older
adults will require addressing the issue at many points along the care
continuum where older adults may need additional attention or a
different approach. AHRQ wants to identify specific tools, strategies
and approaches to opioid management in older adults throughout the
breadth of the care delivery continuum, from avoiding opioid initiation
to screening for opioid misuse and opioid use disorder, as well as
approaches to opioid tapering in older adults.
AHRQ is interested in all innovative approaches that address the
opioid management concerns in older adults listed above, but
respondents are welcome to address as many or as few as they choose and
to address additional areas of interest not listed.
Strategies and approaches could come from a variety of health care
settings including, but not limited to, primary care and other
ambulatory care clinics, emergency departments, home health care
organizations, skilled nursing care settings, and inpatient care. Other
sources of these strategies might include health care payers,
accountable care organizations, and organizations that provide external
quality improvement support. Some of the examples of the types of
innovations we are looking for might be specific tools or workflows
that support providers to assess the risk/benefit balance of opioids
within a multidisciplinary approach in pain management; to optimize and
monitor the opioid prescribing when appropriate, including tapering
strategies; to screen and treat for opioid misuse or opioid use
disorder; or to involve family or other caregivers of an older adult in
conversations about opioid safety. Descriptions of strategies or
approaches should include the setting where it is deployed and the type
of patient population served.
This RFI is for planning purposes only and should not be construed
as a policy, solicitation for applications, or as an obligation on the
part of the Government to provide support for any ideas in response to
it. AHRQ will use the information submitted in response to this RFI at
its discretion, and will not provide comments to any respondent's
submission. However, responses to the RFI may be reflected in future
solicitation(s) or policies. Respondents are advised that the
Government is under no obligation to acknowledge receipt of the
information received or provide feedback to respondents with respect to
any information submitted. No proprietary, classified, confidential or
sensitive information should be included in your response. The
Government reserves the right to use any non-proprietary technical
information in any resultant solicitation(s). The contents of all
submissions will be made available to the public upon request.
Submitted materials must be publicly available or able to be made
public.
Dated: April 21, 2020.
Virginia L. Mackay-Smith,
Associate Director, Office of the Director, AHRQ.
[FR Doc. 2020-08727 Filed 4-23-20; 8:45 am]
BILLING CODE 4160-90-P
