| Title |
Clinician Referrals for Non-opioid Pain Care Following Discontinuation of Long-term Opioid Therapy Differ Based on Reasons for Discontinuation
|
|---|---|
| Published in |
Journal of General Internal Medicine, April 2018
|
| DOI | 10.1007/s11606-018-4329-6 |
| Pubmed ID | |
| Authors |
Travis I. Lovejoy, Benjamin J. Morasco, Michael I. Demidenko, Thomas H. A. Meath, Steven K. Dobscha |
| Abstract |
Little is known about pain care offered to patients discontinued from long-term opioid therapy (LTOT) by their prescriber due to aberrant behaviors versus other reasons. This study aimed to compare rates of non-opioid analgesic pharmacotherapy initiation and clinician referrals for non-pharmacologic pain treatment, complementary and integrative pain therapies, and specialty mental health and substance use disorder treatment between patients discontinued from opioid therapy due to aberrant behaviors versus other reasons. The design included retrospective manual electronic health record review and administrative data abstraction. Patients were sampled from a national cohort of US Department of Veterans Affairs patients prescribed continuous opioid therapy in 2011 who subsequently discontinued opioid therapy in 2012. The study sample comprised 509 patients discontinued from LTOT by opioid-prescribing clinicians. The primary independent variable was reason for discontinuation of LTOT (aberrant behaviors versus other reasons). Pain care dichotomous outcomes included clinician use of an opioid taper; initiating new non-opioid analgesic pharmacotherapy; and referrals for non-pharmacologic pain treatment, complementary and integrative pain therapies, and specialty mental health and substance use disorder treatment. We observed low rates of opioid taper (15% of patients), initiations of new or modifications of existing non-opioid analgesic pharmacotherapy (45% of patients), and clinician referrals for non-pharmacologic pain treatment (58% of patients) and complementary and integrative therapies (25% of patients). Patients discontinued due to aberrant behaviors, relative to patients discontinued for other reasons, were more likely to receive opioid tapers (adjusted OR = 5.60, 95% CI = 2.10-14.93), receive new non-opioid analgesic medications or dose changes to an existing non-opioid analgesic medications (adjusted OR = 2.61, 95% CI = 1.59-4.29), or be referred for specialty substance use disorder treatment (adjusted OR = 7.39, 95% CI = 3.76-14.53). These findings highlight the variability in referral rates for different types of non-opioid pain treatments and challenges accessing specific types of pain care. |
X Demographics
The data shown below were collected from the profiles of 2 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 1 | 50% |
| Unknown | 1 | 50% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 50% |
| Science communicators (journalists, bloggers, editors) | 1 | 50% |
Mendeley readers
The data shown below were compiled from readership statistics for 37 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 37 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Ph. D. Student | 10 | 27% |
| Student > Master | 5 | 14% |
| Researcher | 3 | 8% |
| Other | 2 | 5% |
| Student > Postgraduate | 2 | 5% |
| Other | 3 | 8% |
| Unknown | 12 | 32% |
| Readers by discipline | Count | As % |
|---|---|---|
| Nursing and Health Professions | 6 | 16% |
| Medicine and Dentistry | 5 | 14% |
| Pharmacology, Toxicology and Pharmaceutical Science | 2 | 5% |
| Social Sciences | 2 | 5% |
| Agricultural and Biological Sciences | 1 | 3% |
| Other | 5 | 14% |
| Unknown | 16 | 43% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 10 April 2018.
All research outputs
#18,756,367
of 23,911,072 outputs
Outputs from Journal of General Internal Medicine
#6,408
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Outputs of similar age
#244,170
of 332,610 outputs
Outputs of similar age from Journal of General Internal Medicine
#98
of 129 outputs
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