The impact of practice guidelines on opioid utilization for injured workers

Research output: Contribution to journalArticle

Abstract

Background: Opioid use is rising in the US and may cause special problems in workers compensation cases, including addiction and preventing a return to work after an injury. Objective: This study evaluates a physician-level intervention to curb opioid usage. An insurer identified patients with out-of-guideline opioid utilization and called the prescribing physician to discuss the patient's treatment protocol. Research Design: This study uses a differences-in-differences study design with a propensity-score-matched control group. Medical and pharmaceutical claims data from 2005 to 2011 were used for analyses. Results: Following the intervention, the use of opioids increased for the intervention group and there is little impact on medical spending. Conclusions: Counseling physicians about patients with high opioid utilization may focus more attention on their care, but did not impact short-term outcomes. More robust interventions may be needed to manage opioid use. Perspective: While the increasing use of opioids is of growing concern around the world, curbing the utilization of these powerfully addictive narcotics has proved elusive. This study examines a prescribing guidelines intervention designed to reduce the prescription of opioids following an injury. The study finds that there was little change in the opioid utilization after the intervention, suggesting interventions along other parts of the prescribing pathway may be needed.

Original languageEnglish (US)
JournalAmerican Journal of Industrial Medicine
DOIs
StateAccepted/In press - 2017

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Practice Guidelines
Opioid Analgesics
Physicians
Research Design
Guidelines
Workers' Compensation
Insurance Carriers
Propensity Score
Return to Work
Narcotics
Wounds and Injuries
Clinical Protocols
Prescriptions
Counseling
Control Groups
Pharmaceutical Preparations

Keywords

  • Opioid abuse
  • Prescribing guidelines
  • Propensity score matching
  • Workers' compensation

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

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title = "The impact of practice guidelines on opioid utilization for injured workers",
abstract = "Background: Opioid use is rising in the US and may cause special problems in workers compensation cases, including addiction and preventing a return to work after an injury. Objective: This study evaluates a physician-level intervention to curb opioid usage. An insurer identified patients with out-of-guideline opioid utilization and called the prescribing physician to discuss the patient's treatment protocol. Research Design: This study uses a differences-in-differences study design with a propensity-score-matched control group. Medical and pharmaceutical claims data from 2005 to 2011 were used for analyses. Results: Following the intervention, the use of opioids increased for the intervention group and there is little impact on medical spending. Conclusions: Counseling physicians about patients with high opioid utilization may focus more attention on their care, but did not impact short-term outcomes. More robust interventions may be needed to manage opioid use. Perspective: While the increasing use of opioids is of growing concern around the world, curbing the utilization of these powerfully addictive narcotics has proved elusive. This study examines a prescribing guidelines intervention designed to reduce the prescription of opioids following an injury. The study finds that there was little change in the opioid utilization after the intervention, suggesting interventions along other parts of the prescribing pathway may be needed.",
keywords = "Opioid abuse, Prescribing guidelines, Propensity score matching, Workers' compensation",
author = "Christine Buttorff and Trujillo, {Antonio Jose} and Castillo, {Renan Carlos} and Vecino-Ortiz, {Andres I.} and Anderson, {Gerard F}",
year = "2017",
doi = "10.1002/ajim.22779",
language = "English (US)",
journal = "American Journal of Industrial Medicine",
issn = "0271-3586",
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AU - Trujillo, Antonio Jose

AU - Castillo, Renan Carlos

AU - Vecino-Ortiz, Andres I.

AU - Anderson, Gerard F

PY - 2017

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N2 - Background: Opioid use is rising in the US and may cause special problems in workers compensation cases, including addiction and preventing a return to work after an injury. Objective: This study evaluates a physician-level intervention to curb opioid usage. An insurer identified patients with out-of-guideline opioid utilization and called the prescribing physician to discuss the patient's treatment protocol. Research Design: This study uses a differences-in-differences study design with a propensity-score-matched control group. Medical and pharmaceutical claims data from 2005 to 2011 were used for analyses. Results: Following the intervention, the use of opioids increased for the intervention group and there is little impact on medical spending. Conclusions: Counseling physicians about patients with high opioid utilization may focus more attention on their care, but did not impact short-term outcomes. More robust interventions may be needed to manage opioid use. Perspective: While the increasing use of opioids is of growing concern around the world, curbing the utilization of these powerfully addictive narcotics has proved elusive. This study examines a prescribing guidelines intervention designed to reduce the prescription of opioids following an injury. The study finds that there was little change in the opioid utilization after the intervention, suggesting interventions along other parts of the prescribing pathway may be needed.

AB - Background: Opioid use is rising in the US and may cause special problems in workers compensation cases, including addiction and preventing a return to work after an injury. Objective: This study evaluates a physician-level intervention to curb opioid usage. An insurer identified patients with out-of-guideline opioid utilization and called the prescribing physician to discuss the patient's treatment protocol. Research Design: This study uses a differences-in-differences study design with a propensity-score-matched control group. Medical and pharmaceutical claims data from 2005 to 2011 were used for analyses. Results: Following the intervention, the use of opioids increased for the intervention group and there is little impact on medical spending. Conclusions: Counseling physicians about patients with high opioid utilization may focus more attention on their care, but did not impact short-term outcomes. More robust interventions may be needed to manage opioid use. Perspective: While the increasing use of opioids is of growing concern around the world, curbing the utilization of these powerfully addictive narcotics has proved elusive. This study examines a prescribing guidelines intervention designed to reduce the prescription of opioids following an injury. The study finds that there was little change in the opioid utilization after the intervention, suggesting interventions along other parts of the prescribing pathway may be needed.

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KW - Prescribing guidelines

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KW - Workers' compensation

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