Multidisciplinary Program Reduces Inappropriate Opioid Use

A newly developed program, known as the Chronic Pain Program, was created as a multidisciplinary care management and coaching program that provides support and resources to patients with chronic pain. According to a team of researchers that recently analyzed the program, a multidisciplinary approach to chronic pain management shows promise in reducing inappropriate opioid use.

“The pharmacodynamic component of chronic pain has a significant impact on individual’s quality of life and often medications to address chronic pain are not assessed appropriately,” said lead study researcher Vanessa Zeilinger, PharmD, and colleagues. “It is now evident that the United States is suffering from an opioid crisis due to overuse and overprescribing patterns. This has led to such issues as addiction, misuse, severe drug interactions, and a trend of increasing morphine milligram equivalents (MME) without improving the patients functional status which increases their risk of an adverse event.”

According to the researchers, the program was designed to improve function on an individual level and the pharmacist component of the program, addressing appropriate pharmacotherapy for pain conditions, tapering down opioid therapy when clinically appropriate, and decreasing inappropriate opioid utilization.

In order to measure opioid days supply and MME’s as a marker of decreasing inappropriate opioid utilization, Dr Zeilinger and colleagues identified patients from commercial health plans who were enrolled in the program. Further, the researchers used Propensity Score Matching and included relevant musculoskeletal ICD-10 categories, opioid drug classes, age, and gender.

According to the findings, the researchers observed a decrease in opioid days supply by a mean of 15 in the intervention group compared with a mean of 2 in the control group. Additionally, the intervention group experienced a mean decrease of 57 for MME compared with the control group who had a mean increase of 53. Finally, the lowest tier group had a mean of a 28 days supply decrease and a MME decrease of 57.

“While limited by a small sample size, the multidisciplinary approach to chronic pain management shows promise in reducing inappropriate opioid use and tapering down the MME to decrease the potential of serious side effects,” concluded Dr Zeilinger and colleagues. “The member is supported throughout their enrollment in the program and are able to consult with a clinical pharmacist to discuss medication concerns.” —Julie Gould