Institute for Data Science and Informatics; Missouri Telehealth Network, University of Missouri, Columbia, Missouri.
Institute for Data Science and Informatics; Biomedical Informatics, Biostatistics and Medical Epidemiology (BBME), Columbia, Missouri.
J Opioid Manag. 2024 Mar-Apr;20(2):133-147. doi: 10.5055/jom.0825.
The objective of this study was to assess opioid prescribing patterns of primary care providers (PCPs) participating in a virtual tele-mentoring program for patients with chronic pain as compared to nonparticipants.
We utilized Missouri Medicaid claims from 2013 to 2021 to compare opioid prescription dosages and daily supply of opioids prescribed by PCPs. Participants and nonparticipants were matched using propensity score matching.
Missouri Medicaid data were received through partnership with the Center for Health Policy's MO HealthNet Data Project, the state's leading provider of Medicaid data.
Missouri-based prescribers.
Show-Me Project Extension for Community Healthcare Outcomes (ECHO), an evidence-based provider-to-provider telehealth intervention that connects PCPs with a team of specialists.
We compared the rate of prescription opioid >50 morphine milligram equivalents (MMEs), mean MMEs/day, and mean number of daily supply to understand the impact of the ECHO model on providers' opioid prescribing.
Patients treated by ECHO providers have 33 percent lower odds of being prescribed opioid dose >50 MME/day (p < 0.001) compared to non-ECHO providers. There is also a 14 percent reduction in the average opioid dose prescribed to patients of ECHO providers (p < 0.001). We observed a 3 percent (p < 0.001) reduction in average daily supply of opioids among patients of ECHO providers compared to the comparison group.
Pain Management ECHO supports PCPs with needed education and skills to provide specialty care in the management of pain conditions and safe prescribing of opioid medications.
本研究旨在评估参与慢性疼痛患者虚拟远程指导计划的初级保健提供者（PCP）与非参与者相比的阿片类药物处方模式。
我们利用 2013 年至 2021 年密苏里州医疗补助索赔数据，比较 PCP 开具的阿片类药物处方剂量和每日供应量。使用倾向评分匹配对参与者和非参与者进行匹配。
通过与健康政策中心的 MO HealthNet 数据项目合作，获得密苏里州医疗补助数据，该项目是密苏里州领先的医疗补助数据提供商。
密苏里州的处方医生。
展示项目扩展社区医疗成果（ECHO），这是一种基于证据的提供者对提供者远程医疗干预措施，将 PCP 与一组专家联系起来。
我们比较了处方阿片类药物> 50 吗啡毫克当量（MME）的比率、每日平均 MME 和每日平均供应数量，以了解 ECHO 模式对提供者阿片类药物处方的影响。
与非 ECHO 提供者相比，接受 ECHO 提供者治疗的患者被开具> 50 MME/天的阿片类药物处方的可能性降低了 33%（p < 0.001）。ECHO 提供者为患者开具的阿片类药物平均剂量也降低了 14%（p < 0.001）。与对照组相比，ECHO 提供者的患者阿片类药物的平均每日供应量减少了 3%（p < 0.001）。
疼痛管理 ECHO 为 PCP 提供了所需的教育和技能，以提供专业护理，管理疼痛状况，并安全开具阿片类药物。
