Effect of an opioid management program for Colorado workers' compensation providers on adherence to treatment guidelines for chronic pain. Issue 1 (30th November 2018)

• Record Type: Journal Article
• Authors: Tenney, Liliana; McKenzie, Lisa M.; Matus, Brenden; Mueller, Kathryn; Newman, Lee S.
• Is Part Of: American journal of industrial medicine. Volume 62:Issue 1(2019)
• Page Start: 21
• Page End: 29
• Publication Date: 2018-11-30
• Subjects: chronic pain -- injured worker -- opioid prevention -- opioids -- workers' compensation; Medicine, Industrial -- Periodicals; Médecine du travail -- Périodiques; 616.9803
• DOI: 10.1002/ajim.22920
• Languages: English
• ISSNs: 0271-3586

Abstract

Abstract : Objective: The aim of this study was to examine adherence of state guidelines for Colorado workers' compensation physicians/providers treating individuals as injured workers with chronic pain after initiation of an opioid management program and provider incentives. Methods: A retrospective cohort of chronic, non‐cancer pain claims was constructed from the Colorado's workers' compensation database. Adherence to treatment guidelines and opioid prescribing practices were evaluated during implementation of a new billing code to incentivize adherence. Results: Overall, less than 33% of claims showed evidence of opioid management. Comprehensive opioid management was observed in only 4.4% of claims. In 2010, after implementing the new billing code, the ratio of long acting opioids to short acting opioids decreased from 0.2 to 0.13; returning to 0.2 in one year. Similarly, morphine equivalent doses declined for a short period. Conclusions: Incentivizing physicians to adhere to chronic pain management guidelines only temporarily improves prescribing practices.