Association Between Facility-Level Utilization of Non-pharmacologic Chronic Pain Treatment and Subsequent Initiation of Long-Term Opioid Therapy

Carey, Evan; Nolan, Charlotte; Kerns, Robert D.; Ho, P. Michael; Frank, Janet C.

doi:10.1007/s11606-018-4324-y

Cited by 19 publications

(13 citation statements)

References 29 publications

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“…Some studies investigated opioid use among patients with various specific health conditions: 43 studies 24,26–28,31,37,43,48,49,51,52,59,62,65,70,74,77–80,82–104 focused on noncancer pain, 14 studies 55,56,64,69,105–114 on musculoskeletal conditions, 13 studies 38–40,57,81,115–122 on injuries or trauma and eight studies 23,32,53,67,75,123–125 on infectious diseases. Seven studies 41,44,45,71,126–128 included patients with both cancer and noncancer pain, and six studies evaluated patients with cancer 60,129,130 or cancer survivors 61,131,132 . (Table 1)…”

Section: Resultsmentioning

confidence: 99%

Variations in Long‐term Opioid Therapy Definitions: A Systematic Review of Observational Studies Using Routinely Collected Data (2000‐2019)

Costa

Bruno

Baranwal

et al. 2021

Brit J Clinical Pharma

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Routinely collected data have been increasingly used to assess long‐term opioid therapy (LTOT) patterns, with very little guidance on how to measure LTOT from these data sources. We conducted a systematic review of studies published between January 2000 and July 2019 to catalogue LTOT definitions, the rationale for definitions and LTOT rates in observational research using routinely collected data in nonsurgical settings. We screened 4056 abstracts, 210 full‐text manuscripts and included 128 studies, mostly from the United States (81%) and published between 2015 and 2019 (69%). We identified 78 definitions of LTOT, commonly operationalised as 90 days of use within a year (23%). Studies often used multiple criteria to derive definitions (60%), mostly based on measures of duration, such as supply days/days of use (66%), episode length (21%) or prescription fills within specified time periods (12%). Definitions were based on previous publications (63%), clinical judgment (16%) or empirical data (3%); 10% of studies applied more than one definition. LTOT definition was not provided with enough details for replication in 14 studies and 38 studies did not specify the opioids evaluated. Rates of LTOT within study populations ranged from 0.2% to 57% according to study design and definition used. We observed a substantial rise in the last 5 years in studies evaluating LTOT with large variability in the definitions used and poor reporting of the rationale and implementation of definitions. This variation impacts on research reproducibility, comparability of findings and the development of strategies aiming to curb therapy that is not guideline‐recommended.

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Section: Resultsmentioning

confidence: 99%

Variations in Long‐term Opioid Therapy Definitions: A Systematic Review of Observational Studies Using Routinely Collected Data (2000‐2019)

Costa

Bruno

Baranwal

et al. 2021

Brit J Clinical Pharma

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“…Las intervenciones no farmacológicas descritas en esta revisión presentan una oportunidad para mejorar la calidad de vida, salud, impacto económico y la polifarmacia de personas con FM, incluso el uso de opioides a largo plazo (69,134). Sin embargo, el uso de intervenciones no farmacológicas como tratamiento de primera línea exige que los profesionales del equipo de salud tengan un paradigma común que facilite la coordinación de sus acciones.…”

Section: Discussionunclassified

Recomendaciones clínicas para la rehabilitación de personas con fibromialgia. Una revisión narrativa.

Cuyúl-Vásquez

Fuentes

Vega³

et al. 2021

Rev. Soc. Esp. Dolor.

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“…Health system payers and administrators often are the ones who decide whether de-implementation of some practices will be coupled to implementation of others, 39 such as new pain care modalities. 40,41 They decide whether prescription reduction policies are unilaterally mandated, or permit individualization. Given the lack of evidence on across-the-board opioid reduction outcomes, we favor strategies that attend to the unique needs of the individual patient.…”

Section: Characteristics Of the Interventionmentioning

confidence: 99%

Promoting Patient-Centeredness in Opioid Deprescribing: a Blueprint for De-implementation Science

Kertesz

McCullough²,

Darnall

et al. 2020

J GEN INTERN MED

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A downward trend in opioid prescribing between 2011 and 2018 has brought per-capita opioid prescriptions below the levels of 2006, the earliest year for which the Centers for Disease Control and Prevention has published data. That trend has affected roughly ten million patients who previously received long-term opioid therapy. Any effort to reduce or replace a prior health practice is termed de-implementation. We suggest that the evaluation of opioid prescribing de-implementation has been misdirected, within US policy and health research, resulting in detrimental impacts on patients, their families and clinicians. Policymakers and implementation scientists can address these deficiencies in how we study and how we perform opioid de-implementation by applying an implementation science framework: the Consolidated Framework for Implementation Research. The Consolidated Framework lays out relevant domains of activity (internal, external, etc.) that influence implementation processes and outcomes. It can deepen our understanding of how policies a r e c h o s e n , c o m m u n i c a t e d , a n d c a r r i e d o u t . Policymakers and researchers who embrace this framework will need a better approach to measuring success and failure in health care where both pain and opioids are concerned. This would involve shifting from a reductive focus on opioid prescription counts toward measures that are more effective, holistic, and patient-centered.

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Association Between Facility-Level Utilization of Non-pharmacologic Chronic Pain Treatment and Subsequent Initiation of Long-Term Opioid Therapy

Cited by 19 publications

References 29 publications

Variations in Long‐term Opioid Therapy Definitions: A Systematic Review of Observational Studies Using Routinely Collected Data (2000‐2019)

Variations in Long‐term Opioid Therapy Definitions: A Systematic Review of Observational Studies Using Routinely Collected Data (2000‐2019)

Recomendaciones clínicas para la rehabilitación de personas con fibromialgia. Una revisión narrativa.

Promoting Patient-Centeredness in Opioid Deprescribing: a Blueprint for De-implementation Science

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