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Adherence to Prescription Opioid Monitoring Guidelines among Residents and Attending Physicians in the Primary Care Setting.
- Source :
-
Pain Medicine . Mar2015, Vol. 16 Issue 3, p480-487. 8p. 3 Charts. - Publication Year :
- 2015
-
Abstract
- Objective The aim of this study was to compare adherence to opioid prescribing guidelines and potential opioid misuse in patients of resident vs attending physicians. Design Retrospective cross-sectional study. Setting Large primary care practice at a safety net hospital in New England. Subjects Patients 18-89 years old, with at least one visit to the primary care clinic within the past year and were prescribed long-term opioid treatment for chronic noncancer pain. Methods Data were abstracted from the electronic medical record by a trained data analyst through a clinical data warehouse. The primary outcomes were adherence to any one of two American Pain Society Guidelines: 1) documentation of at least one opioid agreement (contract) ever and 2) any urine drug testing in the past year, and evidence of potential prescription misuse defined as ≥2 early refills. We employed logistic regression analysis to assess whether patients' physician status predicts guideline adherence and/or potential opioid misuse. Results Similar proportions of resident and attending patients had a controlled substance agreement (45.1% of resident patients vs 42.4% of attending patient, P = 0.47) or urine drug testing (58.6% of resident patients vs 63.6% of attending patients, P = 0.16). Resident patients were more likely to have two or more early refills in the past year relative to attending patients (42.8% vs 32.5%; P = 0.004). In the adjusted regression analysis, resident patients were more likely to receive early refills (odds ratio 1.82, 95% confidence interval 1.26-2.62) than attending patients. Conclusions With some variability, residents and attending physicians were only partly compliant with national guidelines. Residents were more likely to manage patients with a higher likelihood of opioid misuse. [ABSTRACT FROM AUTHOR]
- Subjects :
- *ANALGESICS
*CHI-squared test
*CHRONIC pain
*CONFIDENCE intervals
*DRUG prescribing
*HOSPITAL medical staff
*MEDICAL protocols
*NARCOTICS
*PHYSICIANS
*PRIMARY health care
*PROFESSIONS
*RESEARCH funding
*STATISTICAL hypothesis testing
*T-test (Statistics)
*PHYSICIAN practice patterns
*CROSS-sectional method
*RETROSPECTIVE studies
*DATA analysis software
*DESCRIPTIVE statistics
*ODDS ratio
Subjects
Details
- Language :
- English
- ISSN :
- 15262375
- Volume :
- 16
- Issue :
- 3
- Database :
- Academic Search Index
- Journal :
- Pain Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 101622466
- Full Text :
- https://doi.org/10.1111/pme.12602