Use of Strategies to Reduce Risk of Opioid Misuse Is Low

At-risk patients are not monitored closely and are more likely to receive early opioid refills

FRIDAY, March 25 (HealthDay News) -- The use of opioid risk-reduction strategies by primary care physicians is limited, even among patients at particular risk of misuse, according to a study published online Feb. 24 in the Journal of General Internal Medicine.

Joanna L. Starrels, M.D., of the Albert Einstein College of Medicine in Bronx, N.Y., and colleagues investigated the extent to which primary care physicians monitored patients receiving opioids for chronic noncancer pain. The electronic medical records of 1,612 patients who received long-term opioid treatment from eight primary care practices were evaluated. The association between three risk-reduction strategies: any urine drug test, regular office visits, and restricted (one or fewer) refills more than a week early, and risk factors for opioid misuse were analyzed.

The researchers found that 8 percent of patients underwent urine drug testing, 49.8 percent regularly visited the office, and 76.6 percent were restricted in terms of early refills. Risk factors for opioid misuse included age younger than 45 years (29 percent), drug use disorder (7.6 percent), and mental health disorder (48.4 percent). Likelihood of urine drug testing was associated with a drug use or mental health disorder, and with an increasing number of risk factors. Patients with a drug use disorder or with an increasing number of risk factors were less likely to be restricted in terms of early refills. Regular office visits were not associated with any risk factor.

"Our findings reveal disturbingly low use of monitoring strategies," the authors write. "Primary care physicians are not employing all these approaches more intensively for patients at increased risk of misuse."

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