Format

Send to

Choose Destination
Fam Med. 2009 Nov-Dec;41(10):729-34.

Screening for potential prescription opioid misuse in a michigan medicaid population.

Author information

1
Marquette Family Medicine Residency Program, Marquette, Mich, USA.

Abstract

BACKGROUND AND OBJECTIVES:

The study's objective was to identify patients at risk for ineffective pain management using patient-specific opioid prescription data.

METHODS:

We conducted a retrospective review of payer opioid prescription data and patient charts from a rural family medicine group with a residency program. Sixty-one patients were identified who had received three or more prescriptions from two or more providers over a 6-month period. We noted the number of prescriptions and providers, type of medication prescribed, evidence of a medication management agreement (MMA), early refills, increasing doses, frequent telephone calls, reports of lost or stolen medication, history of drug abuse, and proper chart documentation.

RESULTS:

Seventy percent of the patients were female, 35% had a history of drug abuse, 15% had MMAs, and only 55% had accurate office chart documentation. The number of prescriptions in a 6-month period averaged 8.4 (SD=5.5, range 3 to 28). The average number of prescribers was 3.7 (SD=1.8, range 2 to 10). Patients using non-opioid analgesics had 3.2 fewer prescriptions per 6 months and were less likely to have six or more prescriptions (OR=0.24, 95% CI=0.08--0.73) than those on opioids alone. Concurrent use of non-opioid analgesics, escalating opioid dosage, and number of providers best predicted the number of opioid prescriptions.

CONCLUSIONS:

Payer data was useful in identifying patients who receive larger-than-expected numbers of opioid prescriptions and factors associated with those larger prescription numbers.

PMID:
19882397
[Indexed for MEDLINE]
Free full text

Supplemental Content

Full text links

Icon for Society of Teachers of Family Medicine
Loading ...
Support Center