Dataset Information

Impact of Opioid Dose Reduction and Risk Mitigation Initiatives on Chronic Opioid Therapy Patients at Higher Risk for Opioid-Related Adverse Outcomes.

ABSTRACT:

Objective

We aimed to determine if opioid risk reduction initiatives including dose reduction and risk mitigation strategies for chronic noncancer pain patients receiving chronic opioid therapy (COT) had a differential impact on average daily opioid doses of COT patients at higher risk for opioid-related adverse outcomes compared with lower-risk patients.

Design

Interrupted time series.

Setting

Group Health Cooperative (GH), a health care delivery system and insurance within Washington State, between 2006 and 2014.

Population

GH enrollees on COT defined as receiving a supply of 70 or more days of opioids within 90?days using electronic pharmacy data for filled prescriptions.

Methods

We compared the average daily morphine equivalent doses (MED) of COT patients with and without each of the following higher-risk characteristics: mental disorders, substance use disorders, sedative use, and male gender.

Results

In all four pairwise comparisons, the higher-risk subgroup had a higher average daily MED than the lower-risk subgroup across the study period. Adjusted for covariates, modest differences in the annual rate of reduction in average daily MED were noted between higher- and lower-risk subgroups in three pairwise comparisons: those with mental disorders vs without (-8.2?mg/y vs -5.2?mg/y, P?=?0.005), with sedative use vs without (-9.2?mg/y vs -5.8?mg/y, P?=?0.004); mg), in men vs women (-8.8?mg/y vs -5.9?mg/y, P?=?0.01).

Conclusion

Using clinical policy initiatives in a health care system, dose reductions were achieved among COT patients at higher risk for opioid-related adverse outcomes that were at least as large as those among lower-risk patients.

SUBMITTER: Thakral M

PROVIDER: S-EPMC6294398 | biostudies-literature | 2018 Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Impact of Opioid Dose Reduction and Risk Mitigation Initiatives on Chronic Opioid Therapy Patients at Higher Risk for Opioid-Related Adverse Outcomes.

Thakral Manu M Walker Rod L RL Saunders Kathleen K Shortreed Susan M SM Dublin Sascha S Parchman Michael M Hansen Ryan N RN Ludman Evette E Sherman Karen J KJ Von Korff Michael M

Pain medicine (Malden, Mass.) 20181201 12

<h4>Objective</h4>We aimed to determine if opioid risk reduction initiatives including dose reduction and risk mitigation strategies for chronic noncancer pain patients receiving chronic opioid therapy (COT) had a differential impact on average daily opioid doses of COT patients at higher risk for opioid-related adverse outcomes compared with lower-risk patients.<h4>Design</h4>Interrupted time series.<h4>Setting</h4>Group Health Cooperative (GH), a health care delivery system and insurance withi ...[more]

PMID: 29220525

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Dataset Information

Impact of Opioid Dose Reduction and Risk Mitigation Initiatives on Chronic Opioid Therapy Patients at Higher Risk for Opioid-Related Adverse Outcomes.

Objective

Design

Setting

Population

Methods

Results

Conclusion

Publications

Impact of Opioid Dose Reduction and Risk Mitigation Initiatives on Chronic Opioid Therapy Patients at Higher Risk for Opioid-Related Adverse Outcomes.

Similar Datasets

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