Team Members

Anish Agarwal, MD, MPH

Ali Zarina, MD, MS

Research Areas



A scalable, patient-centered approach for “right-sizing” opioid prescribing

Prescription opioids are a driving factor in the opioid epidemic. Despite a growing number of deaths, prescribers wrote nearly a quarter of a billion opioid prescriptions in 2013. Quantifying the appropriate dose and duration of opioids remains a significant challenge in managing acute pain. Provider based interventions and state legislation have aimed to limit prescribing; however, these approaches lack a patient-centered approach.

Recently, we have shown the ability to gather data from telephone based follow-up to inform and guide EMR defaults and reduce opioid prescribing. Though effective, this approach is laborious and time intensive. Our team has also shown the feasibility of text-message reminders for pre and post-operative surgical care to improve outcomes via the Engaged Recovery at Penn (ERAP) Program.

The objective of this project is to develop, implement and evaluate an alternative, scalable approach to ‘right-sizing’ opioid prescribing using ‘Way to Health’ (WTH). We plan to translate our telephone-based follow-up into WTH’s automated text messaging platform and to expand upon ERAP in order to engage patients and guide opioid prescribing. We plan to enroll patients undergoing elective surgical procedures within the departments of orthopedics, sports medicine, neurosurgery and patients treated in the ED for acute painful injuries. We plan to measure patients’ ability to manage pain, functional status, and overall opioid consumption. We will then use the data gathered via WTH to develop, implement, and evaluate EMR defaults in order to‘right-size’ opioid prescribing for specialty-specific encounters and surgical procedures.