Objective: The aim of this study was to examine adherence of state guidelines for Colorado workers' compensation physicians/providers treating individuals as injured workers with chronic pain after initiation of an opioid management program and provider incentives. Methods: A retrospective cohort of chronic, non-cancer pain claims was constructed from the Colorado's workers' compensation database. Adherence to treatment guidelines and opioid prescribing practices were evaluated during implementation of a new billing code to incentivize adherence. Results: Overall, less than 33% of claims showed evidence of opioid management. Comprehensive opioid management was observed in only 4.4% of claims. In 2010, after implementing the new billing code, the ratio of long acting opioids to short acting opioids decreased from 0.2 to 0.13; returning to 0.2 in one year. Similarly, morphine equivalent doses declined for a short period. Conclusions: Incentivizing physicians to adhere to chronic pain management guidelines only temporarily improves prescribing practices.
Compliance; Workers Compensation; Medical management guidelines; Drugs; Drug therapy; Medical treatment; Pain tolerance; Guidelines; Injuries; Preventive medicine; Medical care; Health care; Physicians; Workers; Pharmaceuticals; Work practices;
Author Keywords: chronic pain; injured worker; opioid prevention; opioids; workers' compensation
Liliana Tenney, MPH, Center for Health, Work and Environment, Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, 13001 E. 17th Place, Mail Stop B119 HSC, Aurora, CO 80045
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