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Effect of an opioid management program for Colorado workers’ compensation providers on adherence to treatment guidelines for chronic pain
Author(s) -
Tenney Liliana,
McKenzie Lisa M.,
Matus Brenden,
Mueller Kathryn,
Newman Lee S.
Publication year - 2019
Publication title -
american journal of industrial medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.7
H-Index - 104
eISSN - 1097-0274
pISSN - 0271-3586
DOI - 10.1002/ajim.22920
Subject(s) - medicine , chronic pain , opioid , workers' compensation , incentive , pain management , family medicine , cohort , physical therapy , compensation (psychology) , psychology , receptor , psychoanalysis , economics , microeconomics
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.