• Health services research · Feb 2021

    Changes in early high-risk opioid prescribing practices after policy interventions in Washington State.

    • Jeanne M Sears, John R Haight, Deborah Fulton-Kehoe, Thomas M Wickizer, Jaymie Mai, and Gary M Franklin.
    • Department of Health Services, University of Washington, Seattle, Washington, USA.
    • Health Serv Res. 2021 Feb 1; 56 (1): 49-60.

    ObjectiveTo test associations between several opioid prescribing policy interventions and changes in early (acute/subacute) high-risk opioid prescribing practices.Data SourcesPopulation-based workers' compensation pharmacy billing and claims data, Washington State Department of Labor and Industries (January 2008-June 2015).Study DesignWe used interrupted time series analysis to test associations between three policy intervention timepoints and monthly proportions of population-based measures of high-risk, low-risk, and any workers' compensation-related opioid prescribing. We also tested associations between the policy intervention timepoints and five high-risk opioid prescribing indicators among workers prescribed any opioids within 3 months after injury: (a) >7 cumulative (not necessarily consecutive) days' supply of opioids during the acute phase, (b) high-dose opioids, (c) concurrent sedatives, (d) chronic opioids, and (e) a composite high-risk opioid prescribing indicator.Principal FindingsWithin 3 months after injury, 9 percent of workers were exposed to high-risk and 12 percent to low-risk workers' compensation-related opioid prescribing; 79 percent filled no workers' compensation-related opioid prescription. Among workers prescribed any early (acute/subacute) opioids, the indicator for >7 days' supply of opioids during the acute phase was present for 30 percent, high-dose opioids for 18 percent, concurrent sedatives for 3 percent, and chronic opioids for 2 percent. Beyond a general shift toward more infrequent and lower-risk workers' compensation-related opioid prescribing, each policy intervention timepoint was significantly associated with reductions in specific acute/subacute high-risk opioid prescribing indicators; each of the four specific high-risk opioid prescribing indicators had significant reductions associated with at least one policy.ConclusionsSeveral state-level opioid prescribing policies were significantly associated with safer workers' compensation-related opioid prescribing practices during the first 3 months after injury (acute/subacute phase), which should in turn reduce transition to chronic opioids and associated negative health outcomes.© 2020 Health Research and Educational Trust.

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