In:
Journal of Opioid Management, Weston Medical Publishing, Vol. 12, No. 5 ( 2016-09-01), p. 333-345
Abstract:
Objective: Characterize primary care patients prescribed opioids for chronic noncancer pain (CNCP), explore guideline-recommended opioid-monitoring practices, and investigate predictors of pain agreements.Design: Retrospective chart review.Setting: Primary care clinic at a tertiary academic medical center.Patients: Adults prescribed chronic opioids (three or more monthly prescriptions within a year) for CNCP between April 1, 2014 and April 1, 2015. Patients without CNCP served as controls.Main Outcome Measure: Patient demographics, medical diagnoses, tobacco status, provider status, documentation of guideline-recommended opioid-monitoring practices, pain agreement status, and opioid prescription. Univariate statistics were used to explore differences in patient demographics, comorbidities, and guideline-recommended opioid-monitoring practices by chronic pain and pain agreement status. Logistic regression was used to investigate predictors of agreement status.Results: The clinic had 834 (9 percent) patients on chronic opioids, with 335 on a pain agreement. Documentation of opioid-monitoring practices was lacking. Logistic regression indicated that patients were significantly more likely to be on an agreement if they were Caucasian (adjusted odds ratio [OR] 2.17 [95% CI 1.41, 3.39] ), had a baseline urine drug screen (adjusted OR 10.72 [95% CI 6.16, 19.41]), were prescribed a schedule II controlled medication (adjusted OR 11.92 [95% CI 6.93, 21.62] ), and had risk assessed to some degree (adjusted OR 3.06 [95% CI 1.90, 4.96]).Conclusions: Aside from race, most patient characteristics were not predictive of pain agreement implementation. However, controlled medication of higher schedules and the use of certain guideline-recommended practices were associated with an agreement. Studies are needed to examine whether pain agreement or guideline-adherence influence clinical outcomes.
Type of Medium:
Online Resource
ISSN:
1551-7489
,
1551-7489
DOI:
10.5055/jom.2016.0350
Language:
Unknown
Publisher:
Weston Medical Publishing
Publication Date:
2016
detail.hit.zdb_id:
2397614-7
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