In spite of the risk of potential abuse, addiction and overdose, few primary care physicians take care to perform routine tests that would detect problems, a two-year study has revealed.
Researcher at the Albert Einstein College of Medicine of Yeshiva University began their study of 1,612 primary care patients, who were prescribed opioids for chronic, non-cancer pain, with the theory that physicians at least monitored their higher risk patients. Their research proved them wrong.
Patients considered high risk for developing problems with pain medication included those who were less than 45 years old, had drug or alcohol use disorders, used tobacco or were diagnosed with a mental health disorder.
The researchers, lead by Dr. Joanna Starrels, looked for the use of opioid risk-reduction strategies to see if patients received urine tests, regular office visits or multiple early opioid refills.
No Testing, Early Refills
Some of the research findings included:
- Only 8% of patients ever had a urine test.
- Only 24% of the high-risk patients had a urine test.
- Only half of the patients had regular office visits.
- High-risk patients were not seen more frequently.
- High-risk patients were more likely to get early refills.
Missing Risk-Reduction Opportunities
"We were disturbed to find that patients with a drug use disorder were seen less frequently in the office and were prescribed more early refills than patients without these disorders," said Dr. Starrels in a news release. "We hope that these findings will call attention to this important safety concern."
The researchers said primary care physicians are missing an opportunity to curtail the growing prescription drug abuse problem by not implementing routine risk-reduction strategies.
The recommend urine drug testing, regular face-to-face office visits and restricting refills to a previously agreed-upon schedule.
Source: Starrels JL, et al. "Low Use of Opioid Risk Reduction Strategies in Primary Care Even for High Risk Patients with Chronic Pain." Journal of General Internal Medicine March 2011. Related Information: