[Federal Register Volume 84, Number 224 (Wednesday, November 20, 2019)]
[Notices]
[Pages 64078-64079]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-25152]


-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[30Day-20-19GH]


Agency Forms Undergoing Paperwork Reduction Act Review

    In accordance with the Paperwork Reduction Act of 1995, the Centers 
for Disease Control and Prevention (CDC) has submitted the information 
collection request titled Evaluating the implementation and impact of a 
fall prevention program, including opioid medication management, in a 
hospital discharge setting, to the Office of Management and Budget 
(OMB)for review and approval. CDC previously published a ``Proposed 
Data Collection Submitted for Public Comment and Recommendations'' 
notice on 02/07/2019 to obtain comments from the public and affected 
agencies. CDC received three comments related to the previous notice. 
This notice serves to allow an additional 30 days for public and 
affected agency comments.
    CDC will accept all comments for this proposed information 
collection project. The Office of Management and Budget is particularly 
interested in comments that:
    (a) Evaluate whether the proposed collection of information is 
necessary for the proper performance of the functions of the agency, 
including whether the information will have practical utility;
    (b) Evaluate the accuracy of the agencies estimate of the burden of 
the proposed collection of information, including the validity of the 
methodology and assumptions used;
    (c) Enhance the quality, utility, and clarity of the information to 
be collected;
    (d) Minimize the burden of the collection of information on those 
who are to respond, including, through the use of appropriate 
automated, electronic, mechanical, or other technological collection 
techniques or other forms of information technology, e.g., permitting 
electronic submission of responses; and
    (e) Assess information collection costs.
    To request additional information on the proposed project or to 
obtain a copy of the information collection plan and instruments, call 
(404) 639-7570 or send an email to [email protected]. Direct written comments 
and/or suggestions regarding the items contained in this notice to the 
Attention: CDC Desk Officer, Office of Management and Budget, 725 17th 
Street NW, Washington, DC 20503 or by fax to (202) 395-5806. Provide 
written comments within 30 days of notice publication.

Proposed Project

    Evaluating the implementation and impact of an opioid medication 
management program, in a hospital discharge setting, to reduce falls in 
older adults--New--National Center for Injury Prevention and Control 
(NCIPC), Centers for Disease Control and Prevention (CDC).

Background and Brief Description

    Over one in four older adults report a fall, and one in 10 report a 
fall injury each year. Falls result in serious injuries. They are the 
leading cause of traumatic brain injuries in older adults and 95% of 
hip fractures in older adults are due to falls.
    Certain types of medications, known as psychoactive medications, 
have been associated with an increased fall risk in older adults. 
Psychoactive medications, including opioids and benzodiazepines, affect 
the central nervous system and can cause side effects such as 
dizziness, sedation, confusion, blurred vision, and orthostatic 
hypotension. Opioid prescribing in emergency department settings, 
inpatient settings, and at hospital discharge settings is very common 
and may increase future chronic opioid use. Studies have shown that 
opioid treatments in older adults are associated with significantly 
increased risk of falls, injurious falls, and fractures.
    This data collection will perform a formative evaluation of the 
implementation and impact of a fall prevention program in a hospital 
discharge setting at the University of California, San Francisco 
(UCSF). Components of the program will target opioid medication 
management in the acute and post-acute settings and referral to 
clinically effective programs to reduce the risk of falls and opioid 
misuse. A total of four questionnaires will be administered. (1) The 
Pre-discharge patient questionnaire will be used to survey older adults 
at University of California San Francisco (UCSF) Medical Center while 
in the hospital (before discharge). The questionnaire includes 47 
questions and is expected to take approximately 10 minutes to complete. 
(2) The Post-discharge patient questionnaire will be used to survey the 
older adults that completed the pre-discharge survey three additional 
times (at 14, 30 and 60 days) after being discharged from UCSF Medical 
Center. This questionnaire includes 60 questions and is expected to 
take approximately 10 minutes to complete. (3) The UCSF Clinical staff 
evaluation questionnaire will be used to survey clinical staff at the 
UCSF Medical Center. The questionnaire includes 31 questions and is 
expected to take approximately five minutes to complete. (4) The 
Primary Care Provider (PCP) post-discharge questionnaire will be used 
to survey primary care providers

[[Page 64079]]

involved in the care of patients discharged from USCF. The 
questionnaire includes 11 questions and is expected to take 
approximately five minutes to complete.
    CDC will use the information collected to: (1) Examine post-
discharge use of opioids or alternative therapies for pain management 
among older adult patients, (2) examine post-discharge compliance and 
follow up by older adults with primary care doctors and/or specialist 
referrals for pain management and fall prevention efforts, (3) identify 
rate of readmission for a fall by level of patient compliance and 
follow-up post-discharge, (4) evaluate the uptake of the program by 
clinical staff, and (5) identify opportunities for program and process 
improvement.
    The data collection proposed by this project represents the first 
federal effort to monitor use of opioids and other pain relief 
strategies through implementation of the fall prevention and opioid 
management initiative in a hospital discharge setting to measure impact 
on older adult health outcomes. The total estimated annualized burden 
hours is 541. There are no costs to the respondents other than their 
time.

                                        Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
                                                                                     Number of    Average burden
          Type of respondent                    Form name            Number of     responses per   per response
                                                                    respondents     respondent      (in hours)
----------------------------------------------------------------------------------------------------------------
Older adult Patients..................  Pre-discharge Patient                800               1           10/60
                                         Questionnaire.
                                        Post-discharge Patient               800               3           10/60
                                         Questionnaire.
UCSF clinical staff...................  Clinical Staff                        50               1            5/60
                                         Evaluation
                                         Questionnaire.
Primary care providers (PCP)..........  PCP post discharge                    50               1            5/60
                                         survey.
----------------------------------------------------------------------------------------------------------------


Jeffrey M. Zirger,
Lead, Information Collection Review Office, Office of Scientific 
Integrity, Office of Science, Centers for Disease Control and 
Prevention.
[FR Doc. 2019-25152 Filed 11-19-19; 8:45 am]
 BILLING CODE 4163-19-P