Hilary Mosher, MD, Clinical Associate Professor in General Internal Medicine, has been awarded a 1-year, $100,000 VA Quality Enhancement Research Initiative (QUERI) pilot grant to study effective implementation of opioid-management guidelines for veterans during medical hospitalization, especially those with concurrent chronic pain conditions. Dr. Mosher recently co-authored a guidance statement endorsed by the Society of Hospital Medicine on safer opioid use for acute pain in hospitalized patients, and recently authored recommendations for the assessment of medically hospitalized patients with chronic pain. The goal of the pilot study is to implement these recommendations and determine best practices for standardizing pain treatment and opioid prescription during the inpatient stay to both prevent immediate and long-term adverse outcomes, while helping individuals deal with pain and regain functionality.

The majority of studies concerning chronic pain and opioid use have focused on the outpatient setting, but hospitalists face complex decisions during the treatment of people admitted with pain-related and chronic pain conditions, especially given current concerns about widespread use of opioids and epidemic levels of opioid-related harms. Dr. Mosher and her colleagues, including Drs. Heather Reisinger and Amy O’Shea, will use the QUERI pilot funds to determine the best means of implementing new inpatient guidance statements to improve the quality and safety of pain treatment during hospitalization. If successful, Dr. Mosher could oversee the deployment of this process across the VA health system.