Article Figures & Data
Tables
- Table 1.
Characteristics of Patients Receiving ≥1 Opioid Prescription from March 25, 2013 to September 25, 2016 (n = 2607)
Characteristic n (%) or Mean (±SD) Age, mean (±SD) 45.7 (±13.7) Gender Female 1775 (68.1%) Male 832 (31.9%) Race White 1638 (62.8%) Black 851 (32.6%) Asian 56 (2.2%) Other 55 (2.1%) Unknown 7 (0.3%) Ethnicity Hispanic 70 (2.7%) Non-Hispanic 2085 (80.0%) Unknown 452 (17.3%) Marital status Married 749 (28.7%) Separated/divorced 296 (11.4%) Widowed 143 (5.5%) Single 1406 (53.9%) Unknown 13 (0.5%) Any PHQ-9 n = 1617 Max PHQ-9, mean (±SD) 8.6 (±7.4) Any PHQ ≥10 634 (39.2%) Any BMI n = 2527 Max BMI, mean (±SD) 34.0 (±9.2) Any BMI ≥30 1579 (62.5%) BMI, body mass index; PHQ, Patient Health Questionnaire; SD, standard deviations.
- Table 2.
Opioid-Prescribing Protocol Elements, Opioid Fill Information, and Co-Medications, for Patients with Any Opioid Prescription in Pre- or Post-Intervention Period
Pre-Intervention (n = 1887) Post-Intervention (n = 1532) P-Value Protocol elements Urine drug screen 345 (18.3%) 411 (26.8%) <.0001 ORT completed n/a 90 (5.9%) n/a COMM n/a 73 (4.8%) n/a Opioid treatment agreement 214 (11.3%) 189 (12.3%) .369 No. of elements n/a 0 n/a 1080 (70.5%) 1 n/a 274 (17.9%) ≥2 n/a 178 (11.6%) No longer on opioid 1,075 (57.0%) n/a n/a Still on opioid 812 (43.0%) n/a n/a Opioid fill information Total No. RX, mean (±SD) 7.3 (±10.2) 7.2 (±8.8) .766 Total No. RX, categories 1 710 (37.6%) 585 (38.2%) 2 281 (14.9%) 194 (12.7%) .273 3 113 (6.0%) 102 (6.7%) ≥4 783 (41.5%) 651 (42.5%) Max daily dose (MED)* (n = 1883) (n = 1527) 1 to 50 mg 1657 (88.0%) 1331 (87.2%) 51 to 100 mg 176 (9.4%) 153 (10.0%) .762 >100 mg 50 (2.7%) 43 (2.8%) Co-medications Tramadol 404 (21.4%) 257 (16.8%) .0006 Benzodiazepines 489 (25.9%) 375 (24.5%) .336 Antidepressants 1056 (56.0%) 791 (51.6%) .012 Musculoskeletal agents 580 (30.7%) 453 (29.6%) .460 Anticonvulsants 450 (23.9%) 402 (26.2%) .108 COMM, current opioid misuse measure; MED, morphine-equivalent dose; ORT, opioid risk tool; RX, prescription; SD, standard deviations.
↵* Excludes methadone prescriptions.
- Table 3.
Opioid Outcomes by Whether Patient Received a Urine Drug Screen (UDS), Opioid Risk Tool (ORT), Current Opioid Misuse Measure (COMM) and Opioid Treatment Agreement (OTA)—Post-Intervention Period Cohort (n = 1532)
No UDS (n = 1121) UDS (n = 411) P-Value No ORT (n = 1442) ORT (n = 90) P-Value No COMM (n = 1459) COMM (n = 73) P-Value No OTA (n = 1,343) OTA (n = 189) P-Value Total No. RX, mean (±SD) 5.0 (±7.0) 13.2 (±10.5) <.0002 6.8 (±8.7) 13.8 (±8.5) <.0001 6.6 (±8.6) 18.0 (±8.0) <.0001 6.4 (±8.7) 12.4 (±8.5) <.0001 Total No. RX categories 1 523 (46.6%) 62 (15.1%) 578 (40.1%) 7 (7.8%) 584 (40.0%) < 5 564 (42.05%) 21 (11.1%) 2 164 (14.6%) 30 (7.3%) 189 (13.1%) 5 (5.6%) 194 (13.3%) 0 (0.0%) 187 (13.9%) 7 (3.7%) <.0001 3 87 (7.8%) 15 (3.7%) <.0001 100 (6.9%) < 5† <.0001 102 (7.0%) 0 (0.0%) <.0001 91 (6.8%) 11 (5.8%) ≥4 347 (31.0%) 304 (74.0%) 575 (39.9%) 76 (84.4%) 579 (39.7%) 72 (98.6%) 501 (37.3%) 150 (79.4%) Max daily dose (MED)* (n = 1118) (n = 409) (n = 1438) (n = 89) (n = 1455) (n = 72) (n = 1,339) (n = 188) 1 to 50 mg 1034 (92.5%) 297 (72.6%) 1260 (87.6%) 71 (79.8%) 1285 (88.3%) 46 (63.9%) 1178 (88.0%) 153 (81.4%) 51 to 100 mg 66 (5.9%) 87 (21.3%) <.0001 137 (9.5%) 16 (18.0%) .036 129 (8.9%) 24 (33.3%) <.0001 123 (9.2%) 30 (16.0%) .015 >100 mg 18 (1.6%) 25 (6.1%) 41 (2.9%) < 5 41 (2.8%) < 5 38 (2.8%) 5 (2.7%) Co-medications Tramadol 197 (17.6%) 60 (14.6%) .167 244 (16.9%) 13 (14.4%) .542 244 (16.7%) 13 (17.8%) .809 217 (16.2%) 40 (21.2%) .085 Benzodiazepines 236 (21.1%) 139 (33.8%) <.0001 341 (23.7%) 34 (37.8%) .003 346 (23.7%) 29 (39.7%) .002 310 (23.1%) 65 (34.4%) .0007 Antidepressants 546 (48.7%) 245 (59.6%) .0002 735 (51.0%) 56 (62.2%) .038 743 (50.9%) 48 (65.8%) .013 666 (49.6%) 125 (66.1%) <.0001 Musculoskeletal agents 309 (27.6%) 144 (35.0%) .005 417 (28.9%) 36 (40.0%) .025 425 (29.1%) 28 (38.4%) .092 375 (27.9%) 78 (41.3%) .0002 Anticonvulsants 266 (23.7%) 136 (33.1%) .0002 373 (25.9%) 29 (32.2%) .184 372 (25.5%) 30 (41.1%) .003 331 (24.7%) 71 (37.6%) .0002 - Appendix Table 1.
Opioid-Prescribing Protocol Elements, Opioid Fill Information, and Co-Medications, for Patients with a PHQ≥10 With any Opioid Prescription in Pre- or Post-Intervention Period
Pre-intervention (n = 441) Post-intervention (n = 476) P-value Protocol elements Urine drug screen 95 (21.5%) 164 (34.5%) <.0001 ORT completed n/a 45 (9.5%) n/a COMM n/a 33 (6.9%) n/a Opioid Treatment Agreement 66 (15.0%) 84 (17.7%) .273 No. elements n/a 0 n/a 298 (62.6%) 1 n/a 93 (19.5%) ≥2 n/a 85 (17.9%) No longer on opioid 158 (35.8%) n/a n/a Still on opioid 283 (64.2%) n/a n/a Opioid fill information Total No. RX, mean (±SD) 9.2 (±11.0) 8.4 (±8.9) .217 Total No. RX, categories 1 128 (29.0%) 152 (31.9%) 2 60 (13.6%) 50 (10.5%) .444 3 22 (5.0%) 27 (5.7%) ≥4 231 (52.4%) 247 (51.9%) Max daily dose (MED)* (n = 439) (n = 474) 1 to 50 mg 379 (86.3%) 407 (85.9%) 51 to 100 mg 50 (11.4%) 55 (11.6%) .963 >100 mg 10 (2.3%) 12 (2.5%) Co-medications Tramadol 102 (23.1%) 91 (19.1%) .136 Benzodiazepines 164 (37.2%) 175 (36.7%) .894 Antidepressants 335 (76.0%) 360 (75.6%) .906 Musculoskeletal agents 170 (38.6%) 171 (35.9%) .411 Anticonvulsants 136 (30.8%) 161 (33.8%) .335 COMM, current opioid misuse measure; MED, morphine-equivalent dose; ORT, opioid risk tool; RX, prescription; SD, standard deviations; PHQ, patient health questionnaire.
↵* Excludes methadone prescriptions.
- Appendix Table 2.
Opioid-Prescribing Protocol Elements, Opioid Fill Information, and Co-Medications, for Patients with a BMI ≥30 kg/m2 with any Opioid Prescription in Pre- or Post-Intervention Period
Pre-Intervention (n = 1161) Post-Intervention (n = 963) P-Value Protocol elements Urine drug screen 202 (17.4%) 251 (26.1%) <.0001 ORT completed n/a 60 (6.2%) n/a COMM n/a 49 (5.1%) n/a Opioid treatment agreement 125 (10.8%) 127 (13.2%) .086 No. elements n/a 0 n/a 680 (70.6%) 1 n/a 169 (17.6%) ≥2 n/a 114 (11.8%) No longer on opioid 616 (53.1%) n/a n/a Still on opioid 545 (46.9%) n/a n/a Opioid fill information Total No. RX, mean (±SD) 7.7 (±10.6) 7.6 (±9.0) .811 Total No. RX, categories 1 406 (35.0%) 341 (35.4%) 2 176 (15.2%) 118 (12.3%) .274 3 72 (6.2%) 64 (6.6%) ≥4 507 (43.7%) 440 (45.7%) Max daily dose (MED)* (n = 1158) (n = 958) 1 to 50 mg 1016 (87.7%) 822 (85.8%) 51 to 100 mg 112 (9.7%) 109 (11.4%) .409 >100 mg 30 (2.6%) 27 (2.8%) Co-medications Tramadol 265 (22.8%) 182 (18.9%) .027 Benzodiazepines 298 (25.7%) 247 (25.7%) .992 Antidepressants 685 (59.0%) 534 (55.5%) .100 Musculoskeletal agents 386 (33.3%) 321 (33.3%) .967 Anticonvulsants 310 (26.7%) 287 (29.8%) .113 COMM, current opioid misuse measure; MED, morphine equivalent dose; ORT, opioid risk tool; RX, prescription; SD, standard deviations; BMI, body mass index.
↵* Excludes methadone prescriptions.
