Your patient died: Death reports make the opioid crisis personal for doctors
The form letters from the San Diego County Medical Examiner's Office were supportive but grim.
“This is a courtesy communication to inform you that your patient (Name, Date of Birth) died on (date). Prescription drug overdose was either the primary cause of death or contributed to the death,” said the letters, sent to hundreds of doctors who in the past 12 months had prescribed opioids to patients who later died. “… We hope that you will take this as an opportunity to join us in preventing future deaths from drug overdose.”
The notices were a simple but unusual experiment — part of a growing research effort aimed at finding solutions to the opioid epidemic that is estimated to have killed almost 50,000 people from overdoses last year. They also addressed an almost astonishing gap in the American health-care system — the gulf between the care doctors provide and their knowledge about the consequences for patients. Many doctors who prescribe painkillers may believe that addiction is a problem that happens to other doctors' patients, because they never learn about their own patients who died of an overdose.
The letters were successful, although the effects were modest. Doctors who were informed of their patients' deaths were 7 percent less likely to start new patients on opioids and issued fewer high-dose prescriptions over the next three months, compared with those who did not receive a letter. In total, there was a 9.7 percent reduction in the total amount of opioids they prescribed, according to results published Thursday in the journal Science.
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