Impact of Informed Consent and Education on Care Engagement After Opioid Initiation in the Veterans Health Administration.
J Pain Res
; 15: 1553-1562, 2022.
Article
in En
| MEDLINE
| ID: mdl-35642185
ABSTRACT
Objective:
To ensure all patients receiving long-term opioid therapy (LTOT) understand the risks, benefits and treatment alternatives, the Veterans Health Administration (VHA) released a national policy in 2014 to standardize a signature informed consent (SIC) process. We evaluated the impact of this policy on medical follow-up after LTOT initiation, a guideline recommended practice.Methods:
Using VHA administrative data, we identified patients initiating LTOT between May 2013 and May 2016. We used an interrupted time series design to compare the monthly rates of medical follow-up within 30 days and primary care visits within 3 months after LTOT initiation across three periods 12 months before the policy (Year 1); 12 months after policy release (Year 2); and 12-24 months after policy release, when the SIC process was mandatory (Year 3).Results:
Among the 409,895 patients who experienced 758,416 LTOT initiations, medical follow-up within 30 days and primary care engagement within 3 months increased by 4% between Year 1 and Year 3. Compared to Year 1, patients in Year 3 were 1.12 times more likely to have any medical follow-up (95% CI 1.10, 1.13) and 1.13 times more likely to have a primary care visit (95% CI 1.12, 1.15). Facilities with a greater proportion of patients receiving SIC had increased medical follow-up (RR 1.04, 95% CI 1.01, 1.07) and primary care engagement (RR 1.06, 95% CI 1.03, 1.10).Conclusion:
The VHA's SIC policy is associated with increased medical follow-up among patients initiating LTOT, which may result in improved patient safety and has implications for other healthcare settings.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Type of study:
Guideline
Language:
En
Journal:
J Pain Res
Year:
2022
Document type:
Article
Affiliation country:
United States