Factors that impact initiation of pain management agreements for patients on chronic opioid therapy.
J Opioid Manag
; 19(5): 423-431, 2023.
Article
en En
| MEDLINE
| ID: mdl-37968976
ABSTRACT
OBJECTIVE:
This analysis seeks to understand variables within our institution that impact pain management agreement (PMA) utilization for chronic noncancer pain (CNCP).DESIGN:
Retrospective chart review.SETTING:
Public academic medical center. PATIENTS Adults prescribed an opioid for CNCP between July 2020 and October 2020. MAIN OUTCOMEMEASURE:
We assessed the association between patient demographics, prescription factors, and prescriber factors with the presence of a PMA. Unadjusted rates and chi-square tests were generated for each predictor. Additionally, we performed two multivariable logistic regressions one including all variables and another utilizing a stepwise forward variable selection process to further understand the relationships between predictors and the presence of a PMA.RESULTS:
49.7 percent of patients who received an opioid for CNCP had a PMA on file. One significant predictor of the presence of PMA was prescriber specialty with anesthesia/pain medicine, demonstrating 88 percent compliance. Compared to anesthesia/pain medicine, patients receiving opioids from internal medicine had an odds ratio (OR) of 0.155 (95 percent confidence interval (CI), 0.109-0.220), while patients receiving opioids from family medicine had an OR of 0.122 (95 percent CI, 0.090-0.167). Additionally, patients who received schedule II opioids (as opposed to schedule III/IV opioids), patients with multiple opioid fills in 3 months, middle aged patients, and Black patients were more likely to have a PMA.CONCLUSIONS:
Compliance with PMA within our institution was only 49 percent despite an existing state law mandating use. Our analysis suggests quality improvement interventions should target patients on schedule III/IV opioids who receive their prescriptions from primary care providers.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Dolor Crónico
/
Analgésicos Opioides
Límite:
Adult
/
Humans
/
Middle aged
Idioma:
En
Revista:
J Opioid Manag
Asunto de la revista:
NEUROLOGIA
/
PSICOFISIOLOGIA
/
TERAPIA POR MEDICAMENTOS
Año:
2023
Tipo del documento:
Article