In partnership with a confidential, Tier 1 U.S.-based national health plan
Background
Prescription opioids remain a significant contributor to preventable harm.
While effective for pain when used appropriately, chronic opioid therapy is often complicated by polypharmacy, drug interactions, and variability in adherence and response. These factors increase the risk of treatment failure, dependence, overdose, and adverse events.
Custom Health deployed a nationwide opioid stewardship program to support more appropriate opioid use and improve outcomes across a high-risk population.
Challenge
Risk associated with opioid therapy increases in the presence of polypharmacy.
Patients often receive medications from multiple prescribers and fill prescriptions across multiple pharmacies, limiting visibility into total medication burden. This increases the likelihood of:
- Drug-drug and drug-disease interactions
- Therapeutic duplication
- Gaps in therapy
- Escalating opioid dose without reassessment of benefit
Addressing these issues requires coordinated, longitudinal oversight and sustained engagement over time.
Program Population
8,675 patients receiving chronic opioid therapy at moderate to high doses
- Average age: 64
- 51% female / 49% male
18,738 therapy problems identified, including drug interactions, polypharmacy risks, and therapy gaps
Approach
A longitudinal, technology-enabled model designed to monitor medication use, identify risk, and support ongoing intervention.
- Patients were identified based on opioid utilization and risk of therapy-related complications
- A control group was established to validate outcomes
- Patients were stratified by medication complexity and opioid dosage
- Structured workflows supported ongoing intervention over a 12-month period
Program components included:
- Decision support to identify and prioritize therapy problems
- Targeted engagement with patients and prescribers
- Ongoing review of medication use and patient response
- Standardized processes to ensure consistency across interventions
Results
Over 12 months:
- 27% reduction in average daily opioid dose
(155.4 mg to 113.3 mg morphine equivalent, validated against control) - 62% of opioid-related therapy problems resolved
- 18,738 therapy problems addressed, including interactions, therapy gaps, and polypharmacy risks
“These results reflect the impact of sustained engagement and structured intervention across a complex patient population.” — Downer Dykes, Director of Quality, Analytics and Data Sciences
Why It Matters
These results reflect what becomes possible when medication use is continuously visible, managed, and acted on.
By bringing structure into the home and connecting it to pharmacist-led clinical oversight, Custom Health helps reduce risk, improve safety, and support better outcomes in complex patient populations.
See how this works in practice: Talk to our team →
Client name withheld due to confidentiality obligations.
