RAND Corporation, Arlington, Virginia.
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Am J Ind Med. 2017 Dec;60(12):1023-1030. doi: 10.1002/ajim.22779. Epub 2017 Oct 9.
Opioid use is rising in the US and may cause special problems in workers compensation cases, including addiction and preventing a return to work after an injury.
This study evaluates a physician-level intervention to curb opioid usage. An insurer identified patients with out-of-guideline opioid utilization and called the prescribing physician to discuss the patient's treatment protocol.
This study uses a differences-in-differences study design with a propensity-score-matched control group. Medical and pharmaceutical claims data from 2005 to 2011 were used for analyses.
Following the intervention, the use of opioids increased for the intervention group and there is little impact on medical spending.
Counseling physicians about patients with high opioid utilization may focus more attention on their care, but did not impact short-term outcomes. More robust interventions may be needed to manage opioid use.
While the increasing use of opioids is of growing concern around the world, curbing the utilization of these powerfully addictive narcotics has proved elusive. This study examines a prescribing guidelines intervention designed to reduce the prescription of opioids following an injury. The study finds that there was little change in the opioid utilization after the intervention, suggesting interventions along other parts of the prescribing pathway may be needed.
在美国，阿片类药物的使用正在上升，这可能会给工人赔偿案件带来特殊问题，包括成瘾和受伤后重返工作岗位的障碍。
本研究评估了一种针对医生的干预措施，以遏制阿片类药物的使用。一家保险公司确定了阿片类药物使用超出指南的患者，并致电开处方的医生讨论患者的治疗方案。
本研究采用倾向评分匹配对照组的差异中的差异研究设计。2005 年至 2011 年的医疗和药品索赔数据用于分析。
干预后，干预组的阿片类药物使用增加，而医疗支出几乎没有影响。
就高阿片类药物使用量的患者对医生进行咨询可能会更关注他们的治疗，但对短期结果没有影响。可能需要更有力的干预措施来管理阿片类药物的使用。
虽然阿片类药物使用的增加在全球范围内引起了越来越多的关注，但控制这些具有强大成瘾性的麻醉品的使用一直难以实现。本研究检查了一项旨在减少受伤后开具阿片类药物处方的处方指南干预措施。研究发现，干预后阿片类药物的使用几乎没有变化，这表明需要对处方途径的其他部分进行干预。
