According to a new study, more than 40% of clinics said that they would not take a new patient who was using opioids to manage pain.
Patients who use prescription opioids to manage their pain may have a harder time accessing primary care, according to a new study.
The research, published in the journal JAMA Network Open, found that primary care clinics who were accepting new patients were less likely to take a patient who said that they were using opioids. In fact, more than 40% of clinics said that they would not take a new patient who was using opioids to manage pain.
Finding Care
“These findings are concerning because it demonstrates just how difficult it may be for a patient with chronic pain searching for a primary care physician,” lead study author Pooja Lagisetty told the blog of the University of Michigan.
For the study, researchers cold-called clinics that were accepting new patients. The callers said they were looking for a new provider for their parent, who took a Percocet (oxycodone) each day to manage pain.
The findings confirmed the researchers’ hypothesis that people on opioids have a harder time accessing primary care. Forty percent of the clinics said they would not take the patient, while two-thirds said they would require a preliminary visit before deciding. Seventeen percent said they would need additional information to make a decision.
Pain Refugees
“Anecdotally, we were hearing about patients with chronic pain becoming ‘pain refugees,’ being abruptly tapered from their opioids or having their current physician stop refilling their prescription, leaving them to search for pain relief elsewhere,” Lagisetty said. “However, there have been no studies to quantify the extent of the problem.”
Surprisingly, the researchers found that whether a patient had private insurance or Medicare did not make a difference in whether or not they were accepted as a new patient.
“Our results did not differ by insurance status, which was surprising because previous studies on primary care access have showed that patients on Medicaid tend to have lower access to primary care than those with private insurance,” Lagisetty said. “This may indicate that providers and clinics are not making these decisions to restrict access based upon reimbursement. Larger clinics and community health centers were more likely to accept new patients suggesting that there may be some system level factors that affect access to care.”
The lack of access to primary care is especially concerning in this case because the researchers who called clinics said that the patient was also on medication for high blood pressure and high cholesterol, both of which require regular treatment from a provider.
In addition, having a primary care provider can help people manage their use of opioids and taper off them, if possible.
“We hope to use this information to identify a way for us to fix the policies to have more of a patient-centered approach to pain management,” Lagisetty said. “Everyone deserves equitable access to health care, irrespective of their medical conditions or what medications they may be taking.”
