TY - JOUR
KW - Aberrant
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Analgesics, Opioid/therapeutic use
KW - Chronic Pain/drug therapy
KW - Female
KW - Guideline Adherence/statistics & numerical data
KW - Hospitals, Veterans/statistics & numerical data
KW - Humans
KW - Male
KW - Middle Aged
KW - Non-Cancer
KW - Opioid
KW - pain
KW - Practice Guidelines as Topic
KW - Practice Patterns, Physicians'/statistics & numerical data
KW - Prescribing
KW - primary care
KW - Primary Health Care/statistics & numerical data
KW - Retrospective Studies
KW - United States
KW - Young Adult
AU - R. Sekhon
AU - N. Aminjavahery
AU - C. N. Davis Jr
AU - M. J. Roswarski
AU - C. Robinette
A1 - 
AB - OBJECTIVE: The primary objective of this study was to measure prescribing compliance with the Veterans Affairs/Department of Defense treatment guidelines for chronic non-cancer pain (CNCP) in the primary care setting. We also determined the proportion of subjects who demonstrated aberrant drug-related behaviors (ADRBs) and the patient characteristics associated with them. DESIGN: This is a retrospective chart review. SETTING: Primary care setting in Veterans Affairs Medical Center. SUBJECTS: All patients with CNCP between the ages of 18 and 87 years who received opioid prescriptions for 3 or more consecutive months during a 1-year period (July 2009 to August 2010) were eligible for inclusion. A random sample of 800 patients was selected using pharmacy prescription database. Chi-square test was utilized to analyze associations between ADRB and patient characteristics. RESULTS: About half the patients in our sample had a signed opioid pain care agreement (OPCA), and at least one urine drug test (UDT) was obtained. UDT was positive for an illicit drug/unreported opioid in 19.5% of the patients, and negative for the prescribed drug in 25.2% of the sample. About 10% of the sample population had morphine equivalent dose equal to or greater than 200 mg/day. ADRBs were identified in 22.9% of the patients. Younger age, psychiatric comorbidities, history of substance abuse, and high opioid dose were associated with high risk of ADRB, but the presence of OPCA lowered the risk of ADRB. CONCLUSION: This article studied the prescribing practices of opioids in a primary care setting and can be used to enhance provider education regarding chronic pain guidelines.
BT - Pain medicine (Malden, Mass.)
C5 - Opioids & Substance Use
CP - 10
CY - England
DO - 10.1111/pme.12164
IS - 10
JF - Pain medicine (Malden, Mass.)
N2 - OBJECTIVE: The primary objective of this study was to measure prescribing compliance with the Veterans Affairs/Department of Defense treatment guidelines for chronic non-cancer pain (CNCP) in the primary care setting. We also determined the proportion of subjects who demonstrated aberrant drug-related behaviors (ADRBs) and the patient characteristics associated with them. DESIGN: This is a retrospective chart review. SETTING: Primary care setting in Veterans Affairs Medical Center. SUBJECTS: All patients with CNCP between the ages of 18 and 87 years who received opioid prescriptions for 3 or more consecutive months during a 1-year period (July 2009 to August 2010) were eligible for inclusion. A random sample of 800 patients was selected using pharmacy prescription database. Chi-square test was utilized to analyze associations between ADRB and patient characteristics. RESULTS: About half the patients in our sample had a signed opioid pain care agreement (OPCA), and at least one urine drug test (UDT) was obtained. UDT was positive for an illicit drug/unreported opioid in 19.5% of the patients, and negative for the prescribed drug in 25.2% of the sample. About 10% of the sample population had morphine equivalent dose equal to or greater than 200 mg/day. ADRBs were identified in 22.9% of the patients. Younger age, psychiatric comorbidities, history of substance abuse, and high opioid dose were associated with high risk of ADRB, but the presence of OPCA lowered the risk of ADRB. CONCLUSION: This article studied the prescribing practices of opioids in a primary care setting and can be used to enhance provider education regarding chronic pain guidelines.
PP - England
PY - 2013
SN - 1526-4637; 1526-2375
SP - 1548
EP - 1556
EP - 
T1 - Compliance with opioid treatment guidelines for chronic non-cancer pain (CNCP) in primary care at a Veterans Affairs Medical Center (VAMC)
T2 - Pain medicine (Malden, Mass.)
TI - Compliance with opioid treatment guidelines for chronic non-cancer pain (CNCP) in primary care at a Veterans Affairs Medical Center (VAMC)
U1 - Opioids & Substance Use
U2 - 23746149
U3 - 10.1111/pme.12164
VL - 14
VO - 1526-4637; 1526-2375
Y1 - 2013
ER -