Effect of an opioid management program for Colorado workers’ compensation providers on adherence to treatment guidelines for chronic pain

Tenney, Liliana; McKenzie, Lisa M.; Matus, Brenden; Mueller, Kathryn; Newman, Lee S.

doi:10.1002/ajim.22920

Cited by 6 publications

(5 citation statements)

References 34 publications

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“…21 In response to this opioid crisis in the workplace, a great number of studies have been done through various approaches. 6,13,17,[21][22][23][24][25][26][27][28][29] For studies examining opioid use among workers, most of them consisted of workers' compensation (WC) claimants at the state level. 22,25,28 On the other hand, a couple of studies using national survey and employer-sponsored health care data analyzed opioid use among US workers.…”

Section: Introductionmentioning

confidence: 99%

Prescription opioid use and associated factors among US construction workers

Dong

Brooks

Cain

2020

American J Industrial Med

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Background Construction workers are among the segments of the US population that were hit hardest by the opioid prescription and overdose deaths in the past decades. Factors that underlie opioid use in construction workers have been compartmentalized and isolated in existing studies of opioid use and opioid overdose, but they ignore the overall context of their use. This study examines prescription opioid use and its association with a variety of occupational and nonoccupational factors in construction workers in the United States. Methods Data from the 2011‐2017 Medical Expenditure Panel Survey (n = 7994) were analyzed. The prevalence of prescribed opioid use and the association with occupational and nonoccupational characteristics among construction workers were examined in four multiple logistic regression models. Results The odds of prescription opioid use for workers with occupational injuries was more than triple that of their noninjured counterparts when demographics and occupational factors were controlled (odds ratio = 3.38, 95% confidence interval: 2.38‐4.81). Odds of prescription opioid use were higher in older construction workers, workers who were white, non‐Hispanic, working part‐time, and in poorer health, while Hispanic workers and those without health insurance were much less likely to report prescription opioid use. Conclusions Prescription opioid use among construction workers encompasses both occupational and nonoccupational factors. As an insight into opioid use among construction workers becomes clearer, effectively responding to the opioid crisis remains a challenge.

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Section: Introductionmentioning

confidence: 99%

Prescription opioid use and associated factors among US construction workers

Dong

Brooks

Cain

2020

American J Industrial Med

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“…For example, incentivizing based on patient’s satisfaction/experience of care might have propelled providers to opioid prescription [ 4 , 22 , 23 , 24 ]. For other instances where considering monetary incentives for providers has resulted in mixed outcomes, see [ 25 , 26 ].…”

Section: Resultsmentioning

confidence: 99%

Misalignment of Stakeholder Incentives in the Opioid Crisis

Boloori

Arnetz

Viens

et al. 2020

IJERPH

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The current opioid epidemic has killed more than 446,000 Americans over the past two decades. Despite the magnitude of the crisis, little is known to what degree the misalignment of incentives among stakeholders due to competing interests has contributed to the current situation. In this study, we explore evidence in the literature for the working hypothesis that misalignment rooted in the cost, quality, or access to care can be a significant contributor to the opioid epidemic. The review identified several problems that can contribute to incentive misalignment by compromising the triple aims (cost, quality, and access) in this epidemic. Some of these issues include the inefficacy of conventional payment mechanisms in providing incentives for providers, practice guidelines in pain management that are not easily implementable across different medical specialties, barriers in adopting multi-modal pain management strategies, low capacity of providers/treatments to address opioid/substance use disorders, the complexity of addressing the co-occurrence of chronic pain and opioid use disorders, and patients’ non-adherence to opioid substitution treatments. In discussing these issues, we also shed light on factors that can facilitate the alignment of incentives among stakeholders to effectively address the current crisis.

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“…These guidelines are more likely to be used by occupational medicine physicians who are treating work‐related back pain. Additionally, states have created guidance for prescribing opioids as well as drug formularies, provider education, and other methods to curb the opioid epidemic and provide instruction on safe prescribing 13,78,79 . For example, Washington State saw decreased opioid prescribing rates in those with WC insurance after implementing dosing guidelines 47 .…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, states have created guidance for prescribing opioids as well as drug formularies, provider education, and other methods to curb the opioid epidemic and provide instruction on safe prescribing. 13,78,79 For example, Washington State saw decreased opioid prescribing rates in those with WC insurance after implementing dosing guidelines. 47 Other states have enacted morphine-equivalent daily dose guidelines, with a recent study showing decreased opioid prescribing in two of these states.…”

Section: Short-acting Opioid Prescriptionmentioning

confidence: 99%

Short‐acting opioid prescriptions and Workers' Compensation using the National Ambulatory Medical Care Survey

Thompson,

Govindarajulu,

Doucette

et al. 2024

American J Industrial Med

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BackgroundShort‐acting opioids have been utilized for pain management with little known about their use in patients on Workers' Compensation (WC) insurance. Our goal was to investigate this association in the ambulatory care setting.MethodsUsing the National Ambulatory Medical Care Survey, visits from patients aged 18–64 during the years 2010 until 2018 were evaluated (excluding 2017 due to data availability). Demographic and co‐morbidity data from each visit was obtained along with the visit year. The first short‐acting opioid medication prescribed in the database was considered. Survey‐weighted frequencies were evaluated. Logistic regression estimated the crude and adjusted odds ratios (OR) with 95% confidence intervals for the use of short‐acting opioid prescription.ResultsThere were 155,947 included visits with 62.5% for female patients. Most patients were White with 11.7% identifying as Black, and 6% identifying as another race. Over 13% of the sample was of Hispanic descent. WC was the identified insurance type in 1.6% of the sample population. Of these patients, 25.6% were prescribed a short‐acting opioid, compared with 10.1% of those with another identified insurance. On multivariable regression, Black patients had increased odds of being prescribed a short‐acting opioid compared to white patients (OR: 1.22, 95% CI: 1.11–1.34). Those on WC had 1.7‐fold higher odds of being prescribed short‐acting opioids (95% CI: 1.46–2.06).ConclusionCertain patient characteristics, including having WC insurance, increased the odds of a short‐acting opioid prescription. Further work is needed to identify prescribing patterns in specific high‐risk occupational groups, as well as to elicit potential associated health outcomes.

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Effect of an opioid management program for Colorado workers’ compensation providers on adherence to treatment guidelines for chronic pain

Cited by 6 publications

References 34 publications

Prescription opioid use and associated factors among US construction workers

Prescription opioid use and associated factors among US construction workers

Misalignment of Stakeholder Incentives in the Opioid Crisis

Short‐acting opioid prescriptions and Workers' Compensation using the National Ambulatory Medical Care Survey

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