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Tag: prescribing opioids

  • Patients On Opioids May Have A Harder Time Finding Primary Care

    Patients On Opioids May Have A Harder Time Finding Primary Care

    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.”

    View the original article at thefix.com

  • Can Taking Opioids During A Hospital Stay Lead To Long-Term Risk?

    Can Taking Opioids During A Hospital Stay Lead To Long-Term Risk?

    Researchers found that 48% of patients who had never before had opioids were given opioids during their hospital admission.

    While the medical community has rethought outpatient opioid use in recent years and drastically reduced prescriptions, little has changed in the way that opioids are prescribed to patients in a hospital setting.

    Now, a new study indicates that receiving opioids even in a hospital setting can increase a patient’s risk of long-term opioid use.

    The study, published in the journal Annals of Internal Medicine, found that prescribing opioids is still extremely common for hospitalized patients.

    “I was surprised by the level of opioid prescribing to patients without a history of opioid use,” lead author Julie Donohue, professor in Pitt Public Health’s Department of Health Policy and Management, told Science Daily. “About half of the people admitted to the hospital for a wide variety of medical conditions were given opioids. The stability of this prescribing also was surprising. Nationally and regionally, as people have become more aware of how addictive opioids can be, we’ve seen declines in outpatient opioid prescribing. But we didn’t see that in inpatient prescribing.”

    In fact, researchers found that 48% of patients who had never before had opioids were given opioids during their hospital admission.

    The study, which looked at 191,249 hospitalizations between 2010 and 2014, found that people who were prescribed opioids for the first time in an inpatient setting were twice as likely to still be using opioids three months after they were discharged, compared with those who did not receive opioids in the hospital.

    The time when people were given opioids also made a difference in their long-term use of the drugs. Only 3.9% of people who had no opioids for 24 hours before their discharge were still using opioids three months later. By comparison, 7.5% of patients who took opioids within 12 hours of discharge reported long-term use.

    The study also found that opioids were often the first line response to pain. Less dangerous options like over-the-counter painkillers were given first only 8% of the time, researchers found.

    “Inpatient opioid use has been something of a black box,” Donohue said. “And, while our study could not assess the appropriateness of opioid administration, we identified several practices—low use of non-opioid painkillers, continuous use of opioids while hospitalized, opioid use shortly before discharge—which may be opportunities to reduce risk of outpatient opioid use and warrant further study.”

    Another recent study found that about half of patients who underwent surgery were able to manage their pain without opioids, using just over-the-counter painkillers. Research like that indicates that opioids are likely unnecessary for some patients who receive them, even in a hospital setting.

    “There are alternatives to opioids for surgical pain that work well and we should be using them more,” said lead study author Michael Englesbe.

    View the original article at thefix.com