Differences in opioid prescription rates between patients with musculoskeletal disorders enrolled in coordinated ambulatory healthcare and patients receiving usual care: a retrospective observational cohort study
Objectives To compare opioid prescription rates between patients enrolled in coordinated ambulatory care and patients receiving usual care.Design In this retrospective cohort study, we analysed claims data for insured patients with non-specific/specific back pain or osteoarthritis of hip or knee fro...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2022-08-01
|
| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/8/e062657.full |
| _version_ | 1811309485039288320 |
|---|---|
| author | Marjan Van Den Akker Ferdinand M Gerlach Martin Beyer Renate Klaassen-Mielke Robin Brünn Angelina Müller Olga Anastasia Amberger Anastasiya Glushan Claudia Witte Kateryna Karimova |
| author_facet | Marjan Van Den Akker Ferdinand M Gerlach Martin Beyer Renate Klaassen-Mielke Robin Brünn Angelina Müller Olga Anastasia Amberger Anastasiya Glushan Claudia Witte Kateryna Karimova |
| author_sort | Marjan Van Den Akker |
| collection | DOAJ |
| description | Objectives To compare opioid prescription rates between patients enrolled in coordinated ambulatory care and patients receiving usual care.Design In this retrospective cohort study, we analysed claims data for insured patients with non-specific/specific back pain or osteoarthritis of hip or knee from 2014 to 2017.Setting The study was based on administrative data provided by the statutory health insurance fund ‘Allgemeine Ortskrankenkasse’, in the state of Baden-Wurttemberg, Germany.Participants The intervention group consisted of patients enrolled in a coordinated ambulatory healthcare model; the control group included patients receiving usual care. Outcomes were overall strong and weak opioid prescriptions. Generalised linear regression models were used to analyse the effect of the intervention.Results Overall, 46 001 (non-specific 18 787/specific 27 214) patients with back pain and 19 366 patients with osteoarthritis belonged to the intervention group, and 7038 (2803/4235) and 963 patients to the control group, respectively. No significant difference in opioid prescriptions existed between the groups. However, the chance of being prescribed strong opioids was significantly lower in the intervention group (non-specific back pain: Odds Ratio (OR) 0.735, 95% Confidential Interval (CI) 0.563 to 0.960; specific back pain: OR 0.702, 95% CI 0.577 to 0.852; osteoarthritis: OR 0.644, 95% CI 0.464 to 0.892). The chance of being prescribed weak opioids was significantly higher in patients with specific back pain (OR 1.243, 95% CI 1.032 to 1.497) and osteoarthritis (OR 1.493, 95% CI 1.037 to 2.149) in the intervention group.Conclusion Coordinated ambulatory healthcare appears to be associated with a lower prescription rate for strong opioids in patients with chronic musculoskeletal disorders.Trial registration number German Clinical Trials Register (DRKS00017548). |
| first_indexed | 2024-04-13T09:42:45Z |
| format | Article |
| id | doaj.art-4c5b51755fca4b1fa63199126066a094 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-04-13T09:42:45Z |
| publishDate | 2022-08-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-4c5b51755fca4b1fa63199126066a0942022-12-22T02:51:51ZengBMJ Publishing GroupBMJ Open2044-60552022-08-0112810.1136/bmjopen-2022-062657Differences in opioid prescription rates between patients with musculoskeletal disorders enrolled in coordinated ambulatory healthcare and patients receiving usual care: a retrospective observational cohort studyMarjan Van Den Akker0Ferdinand M Gerlach1Martin Beyer2Renate Klaassen-Mielke3Robin Brünn4Angelina Müller5Olga Anastasia Amberger6Anastasiya Glushan7Claudia Witte8Kateryna Karimova9Institute of General Practice, Goethe-Universitat Frankfurt am Main, Frankfurt am Main, GermanyInstitute of General Practice, Goethe University Frankfurt, Frankfurt am Main, GermanyInstitute of General Practice, Goethe University Frankfurt, Frankfurt am Main, GermanyDepartment of Medical Informatics, Biometry and Epidemiology, Ruhr University, Bochum, GermanyInstitute of General Practice, Goethe-Universitat Frankfurt am Main, Frankfurt am Main, GermanyInstitute of General Practice, Goethe University, Frankfurt am Main, GermanyInstitute of General Practice, Goethe University, Frankfurt am Main, GermanyInstitute of General Practice, Goethe University, Frankfurt am Main, GermanyInstitute for Applied Quality Improvement and Research in Health Care, AQUA, Gottingen, GermanyInstitute of General Practice, Goethe University, Frankfurt am Main, GermanyObjectives To compare opioid prescription rates between patients enrolled in coordinated ambulatory care and patients receiving usual care.Design In this retrospective cohort study, we analysed claims data for insured patients with non-specific/specific back pain or osteoarthritis of hip or knee from 2014 to 2017.Setting The study was based on administrative data provided by the statutory health insurance fund ‘Allgemeine Ortskrankenkasse’, in the state of Baden-Wurttemberg, Germany.Participants The intervention group consisted of patients enrolled in a coordinated ambulatory healthcare model; the control group included patients receiving usual care. Outcomes were overall strong and weak opioid prescriptions. Generalised linear regression models were used to analyse the effect of the intervention.Results Overall, 46 001 (non-specific 18 787/specific 27 214) patients with back pain and 19 366 patients with osteoarthritis belonged to the intervention group, and 7038 (2803/4235) and 963 patients to the control group, respectively. No significant difference in opioid prescriptions existed between the groups. However, the chance of being prescribed strong opioids was significantly lower in the intervention group (non-specific back pain: Odds Ratio (OR) 0.735, 95% Confidential Interval (CI) 0.563 to 0.960; specific back pain: OR 0.702, 95% CI 0.577 to 0.852; osteoarthritis: OR 0.644, 95% CI 0.464 to 0.892). The chance of being prescribed weak opioids was significantly higher in patients with specific back pain (OR 1.243, 95% CI 1.032 to 1.497) and osteoarthritis (OR 1.493, 95% CI 1.037 to 2.149) in the intervention group.Conclusion Coordinated ambulatory healthcare appears to be associated with a lower prescription rate for strong opioids in patients with chronic musculoskeletal disorders.Trial registration number German Clinical Trials Register (DRKS00017548).https://bmjopen.bmj.com/content/12/8/e062657.full |
| spellingShingle | Marjan Van Den Akker Ferdinand M Gerlach Martin Beyer Renate Klaassen-Mielke Robin Brünn Angelina Müller Olga Anastasia Amberger Anastasiya Glushan Claudia Witte Kateryna Karimova Differences in opioid prescription rates between patients with musculoskeletal disorders enrolled in coordinated ambulatory healthcare and patients receiving usual care: a retrospective observational cohort study BMJ Open |
| title | Differences in opioid prescription rates between patients with musculoskeletal disorders enrolled in coordinated ambulatory healthcare and patients receiving usual care: a retrospective observational cohort study |
| title_full | Differences in opioid prescription rates between patients with musculoskeletal disorders enrolled in coordinated ambulatory healthcare and patients receiving usual care: a retrospective observational cohort study |
| title_fullStr | Differences in opioid prescription rates between patients with musculoskeletal disorders enrolled in coordinated ambulatory healthcare and patients receiving usual care: a retrospective observational cohort study |
| title_full_unstemmed | Differences in opioid prescription rates between patients with musculoskeletal disorders enrolled in coordinated ambulatory healthcare and patients receiving usual care: a retrospective observational cohort study |
| title_short | Differences in opioid prescription rates between patients with musculoskeletal disorders enrolled in coordinated ambulatory healthcare and patients receiving usual care: a retrospective observational cohort study |
| title_sort | differences in opioid prescription rates between patients with musculoskeletal disorders enrolled in coordinated ambulatory healthcare and patients receiving usual care a retrospective observational cohort study |
| url | https://bmjopen.bmj.com/content/12/8/e062657.full |
| work_keys_str_mv | AT marjanvandenakker differencesinopioidprescriptionratesbetweenpatientswithmusculoskeletaldisordersenrolledincoordinatedambulatoryhealthcareandpatientsreceivingusualcarearetrospectiveobservationalcohortstudy AT ferdinandmgerlach differencesinopioidprescriptionratesbetweenpatientswithmusculoskeletaldisordersenrolledincoordinatedambulatoryhealthcareandpatientsreceivingusualcarearetrospectiveobservationalcohortstudy AT martinbeyer differencesinopioidprescriptionratesbetweenpatientswithmusculoskeletaldisordersenrolledincoordinatedambulatoryhealthcareandpatientsreceivingusualcarearetrospectiveobservationalcohortstudy AT renateklaassenmielke differencesinopioidprescriptionratesbetweenpatientswithmusculoskeletaldisordersenrolledincoordinatedambulatoryhealthcareandpatientsreceivingusualcarearetrospectiveobservationalcohortstudy AT robinbrunn differencesinopioidprescriptionratesbetweenpatientswithmusculoskeletaldisordersenrolledincoordinatedambulatoryhealthcareandpatientsreceivingusualcarearetrospectiveobservationalcohortstudy AT angelinamuller differencesinopioidprescriptionratesbetweenpatientswithmusculoskeletaldisordersenrolledincoordinatedambulatoryhealthcareandpatientsreceivingusualcarearetrospectiveobservationalcohortstudy AT olgaanastasiaamberger differencesinopioidprescriptionratesbetweenpatientswithmusculoskeletaldisordersenrolledincoordinatedambulatoryhealthcareandpatientsreceivingusualcarearetrospectiveobservationalcohortstudy AT anastasiyaglushan differencesinopioidprescriptionratesbetweenpatientswithmusculoskeletaldisordersenrolledincoordinatedambulatoryhealthcareandpatientsreceivingusualcarearetrospectiveobservationalcohortstudy AT claudiawitte differencesinopioidprescriptionratesbetweenpatientswithmusculoskeletaldisordersenrolledincoordinatedambulatoryhealthcareandpatientsreceivingusualcarearetrospectiveobservationalcohortstudy AT katerynakarimova differencesinopioidprescriptionratesbetweenpatientswithmusculoskeletaldisordersenrolledincoordinatedambulatoryhealthcareandpatientsreceivingusualcarearetrospectiveobservationalcohortstudy |