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Impact of initiatives to reduce prescription opioid risks on medically attended injuries in people using chronic opioid therapy.
- Source :
-
Pharmacoepidemiology and drug safety [Pharmacoepidemiol Drug Saf] 2019 Jan; Vol. 28 (1), pp. 90-96. Date of Electronic Publication: 2018 Oct 30. - Publication Year :
- 2019
-
Abstract
- Purpose: The purpose of the study is to determine whether initiatives to improve the safety of opioid prescribing decreased injuries in people using chronic opioid therapy (COT).<br />Methods: We conducted an interrupted time series analysis using data from Group Health (GH), an integrated health care delivery system in the United States. In 2007, GH implemented initiatives which substantially reduced daily opioid dose and increased patient monitoring. Among GH members age 18 or older receiving COT between 2006 and 2014, we compared injury rates for patients in GH's integrated group practice (IGP; exposed to the initiatives) vs patients cared for by contracted providers (not exposed). Injuries were identified using a validated algorithm. We calculated injury incidence during the baseline (preintervention) period from 2006 to 2007; the dose reduction period, 2008 to 2010; and the risk stratification and monitoring period, 2010 to 2014. Using modified Poisson regression, we estimated adjusted relative risks (RRs) representing the relative change per year in injury rates.<br />Results: Among 21 853 people receiving COT in the IGP and 8260 in contracted care, there were 2679 injuries during follow-up. The baseline injury rate was 1.0% per calendar quarter in the IGP and 0.9% in contracted care. Risk reduction initiatives did not decrease injury rates: Within the IGP, the RR in the dose reduction period was 1.01 (95% CI, 0.95-1.07) and in the risk stratification and monitoring period, 0.99 (95% CI, 0.95-1.04). Injury trends did not differ between the two care settings.<br />Conclusions: Risk reduction initiatives did not decrease injuries in people using COT.<br /> (© 2018 John Wiley & Sons, Ltd.)
- Subjects :
- Adult
Aged
Craniocerebral Trauma etiology
Delivery of Health Care, Integrated organization & administration
Drug Prescriptions standards
Drug Prescriptions statistics & numerical data
Female
Follow-Up Studies
Health Plan Implementation
Humans
Incidence
Interrupted Time Series Analysis
Male
Middle Aged
Practice Guidelines as Topic
Practice Patterns, Physicians' statistics & numerical data
Program Evaluation
United States
Analgesics, Opioid adverse effects
Chronic Pain drug therapy
Craniocerebral Trauma epidemiology
Delivery of Health Care, Integrated standards
Practice Patterns, Physicians' standards
Subjects
Details
- Language :
- English
- ISSN :
- 1099-1557
- Volume :
- 28
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Pharmacoepidemiology and drug safety
- Publication Type :
- Academic Journal
- Accession number :
- 30375121
- Full Text :
- https://doi.org/10.1002/pds.4678