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Sentinel opioid prescribing measures

The seven opioid prescribing sentinel measures 

  1. Rate of prescribing an index opioid prescription. 
  2. Rate of prescribing an index opioid prescription over the recommended dose.
  3. Rate of prescribing more than 700 cumulative morphine milligram equivalence (MME) during the acute and post-acute pain period.
  4. Rate of prescribing chronic opioid analgesic therapy.
  5. Rate of prescribing high-dose (≥ 90 MME/day) chronic opioid analgesic therapy.
  6. Rate of prescribing concomitant opioid and benzodiazepine therapy.
  7. Percent of patients on chronic opioid analgesic therapy who receive opioids from multiple providers. 

Measure terminology

Index opioid prescription: The first opioid prescription after at least 90 days of opioid naiveté.

Opioid naïve user: A patient prescribed an opioid medication who does not have an active opioid prescription in the 90 day period prior to the index opioid prescription. 

Morphine milligram equivalence (MME): The equianalgesic of a specific dose and formulation of opioids to parenteral morphine. Standard conversion ratios are used to calculate each opioid’s equianalgesic dose. 

  • MME conversion formula (total MME of prescription): (Drug Strength)*(Drug Quantity)*(MME Conversion Factor) 
  • MME conversion formula (Daily MME): (Drug Strength)*(Drug Quantity)*(MME Conversion Factor) / (Days Supply) 

Cumulative morphine milligram equivalence: The sum of the total MME of each opioid prescription received in a given timeframe.

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