TY - JOUR AU - Pasquale, PhD, Margaret K. AU - Sheer, BA, Richard L. AU - Mardekian, PhD, Jack AU - Masters, MS, MPH, Elizabeth T. AU - Patel, PharmD, PhD, Nick C. AU - Hurwitch, PharmD, BCPS, Amy R. AU - Weber, PharmD, MS, BCPS, CGP, BCACP, Jennifer J. AU - Jorga, MD, Anamaria AU - Roland, PharmD, MS, Carl L. PY - 2017/09/01 Y2 - 2024/03/28 TI - Educational intervention for physicians to address the risk of opioid abuse JF - Journal of Opioid Management JA - J of Opioid Management VL - 13 IS - 5 SE - Articles DO - 10.5055/jom.2017.0399 UR - https://wmpllc.org/ojs/index.php/jom/article/view/735 SP - 303-313 AB - <p><strong><em>Objective: </em></strong><em>To evaluate the impact of a pilot intervention for physicians to support their treatment of patients at risk for opioid abuse.</em></p><p><strong><em>Setting, design and patients, participants: </em></strong><em>Patients at risk for opioid abuse enrolled in Medicare plans were identified from July 1, 2012 to April 30, 2014 (N = 2,391), based on a published predictive model, and linked to 4,353 opioid-prescribing physicians. Patient-physician clusters were randomly assigned to one of four interventions using factorial design.</em></p><p><strong><em>Interventions: </em></strong><em>Physicians received one of the following: Arm 1, patient information; Arm 2, links to educational materials for diagnosis and management of pain; Arm 3, both patient information and links to educational materials; or Arm 4, no communication.</em></p><p><strong><em>Main outcome measures: </em></strong><em>Difference-in-difference analyses compared opioid and pain prescriptions, chronic high-dose opioid use, uncoordinated opioid use, and opioid-related emergency department (ED) visits. Logistic regression compared diagnosis of opioid abuse between cases and controls postindex.</em></p><p><strong><em>Results: </em></strong><em>Mailings had no significant impact on numbers of opioid or pain medications filled, chronic high-dose opioid use, uncoordinated opioid use, ED visits, or rate of diagnosed opioid abuse. Relative to Arm 4, odds ratios (95% CI) for diagnosed opioid abuse were Arm 1, 0.95(0.63-1.42); Arm 2, 0.83(0.55-1.27); Arm 3, 0.72(0.46-1.13). While 84.7 percent had </em>≥ <em>1 psychiatric diagnoses during preindex (p = 0.89 between arms), only 9.5 percent had </em>≥ <em>1 visit with mental health specialists (p = 0.53 between arms).</em></p><p><strong><em>Conclusions: </em></strong><em>Although this intervention did not affect pain-related outcomes, future interventions involving care coordination across primary care and mental health may impact opioid abuse and improve quality of life of patients with pain. </em></p> ER -