Chronic opioid therapy and preventive services in rural primary care: An Oregon rural practice-based research network study

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

PURPOSE: For clinicians, using opioid therapy for chronic noncancer pain (CNCP) often gives rise to a confl ict between treating their patients' pain and fears of addiction, diversion of medication, or legal action. Consequent stresses on clinical encounters might adversely affect some elements of clinical care. We evaluated a possible association between chronic opioid therapy (COT) for CNCP and receipt of various preventive services. METHODS: We conducted a retrospective cohort study in 7 primary care clinics within the Oregon Rural Practice-based Research Network (ORPRN). Using medical records of 704 patients, aged 35 to 85 years, seen during a 3-year period, we compared the receipt of 4 preventive services between patients on COT for CNCP and patients not on chronic opioid therapy (non-COT). We used multivariate log-binomial regression analyses to estimate the relative risk of receipt of each preventive service. RESULTS: After adjustment for plausible confounders, we found that patients using COT had a statistically signifi cantly lower relative risk (RR) of receipt of cervical cancer screening (RR = 0.60; 95% confi dence interval [CI], 0.47-0.76) and colorectal cancer screening (RR = 0.42; 95% CI, 0.22-0.80) when compared with non-COT patients. The RR was reduced, without statistical signifi cance, for lipid screening (RR = 0.77; 95% CI, 0.54-1.10), and not notably reduced for smoking cessation counseling (RR = 0.95; 95% CI, 0.78-1.15). CONCLUSIONS: Patients using COT for CNCP were less likely to receive some preventive services. Research is needed to better understand barriers to and improved methods for providing preventive services for these patients.

Original languageEnglish (US)
Pages (from-to)237-244
Number of pages8
JournalAnnals of Family Medicine
Volume8
Issue number3
DOIs
StatePublished - May 2010

Fingerprint

Opioid Analgesics
Primary Health Care
Research
Chronic Pain
Therapeutics
Early Detection of Cancer
Smoking Cessation
Uterine Cervical Neoplasms
Fear
Medical Records
Counseling
Colorectal Neoplasms
Cohort Studies
Retrospective Studies
Regression Analysis
Lipids
Pain

Keywords

  • Chronic pain
  • Family practice
  • Health disparities
  • Health services research
  • Opioid therapy
  • Practice-based research
  • Preventive services
  • Primary health care
  • Rural health care

ASJC Scopus subject areas

  • Family Practice

Cite this

@article{7f28135263fc4789b9ee9e58995ad933,
title = "Chronic opioid therapy and preventive services in rural primary care: An Oregon rural practice-based research network study",
abstract = "PURPOSE: For clinicians, using opioid therapy for chronic noncancer pain (CNCP) often gives rise to a confl ict between treating their patients' pain and fears of addiction, diversion of medication, or legal action. Consequent stresses on clinical encounters might adversely affect some elements of clinical care. We evaluated a possible association between chronic opioid therapy (COT) for CNCP and receipt of various preventive services. METHODS: We conducted a retrospective cohort study in 7 primary care clinics within the Oregon Rural Practice-based Research Network (ORPRN). Using medical records of 704 patients, aged 35 to 85 years, seen during a 3-year period, we compared the receipt of 4 preventive services between patients on COT for CNCP and patients not on chronic opioid therapy (non-COT). We used multivariate log-binomial regression analyses to estimate the relative risk of receipt of each preventive service. RESULTS: After adjustment for plausible confounders, we found that patients using COT had a statistically signifi cantly lower relative risk (RR) of receipt of cervical cancer screening (RR = 0.60; 95{\%} confi dence interval [CI], 0.47-0.76) and colorectal cancer screening (RR = 0.42; 95{\%} CI, 0.22-0.80) when compared with non-COT patients. The RR was reduced, without statistical signifi cance, for lipid screening (RR = 0.77; 95{\%} CI, 0.54-1.10), and not notably reduced for smoking cessation counseling (RR = 0.95; 95{\%} CI, 0.78-1.15). CONCLUSIONS: Patients using COT for CNCP were less likely to receive some preventive services. Research is needed to better understand barriers to and improved methods for providing preventive services for these patients.",
keywords = "Chronic pain, Family practice, Health disparities, Health services research, Opioid therapy, Practice-based research, Preventive services, Primary health care, Rural health care",
author = "David Buckley and James Calvert and Jodi Lapidus and Cynthia Morris",
year = "2010",
month = "5",
doi = "10.1370/afm.1114",
language = "English (US)",
volume = "8",
pages = "237--244",
journal = "Annals of Family Medicine",
issn = "1544-1709",
publisher = "Annals of Family Medicine, Inc",
number = "3",

}

TY - JOUR

T1 - Chronic opioid therapy and preventive services in rural primary care

T2 - An Oregon rural practice-based research network study

AU - Buckley, David

AU - Calvert, James

AU - Lapidus, Jodi

AU - Morris, Cynthia

PY - 2010/5

Y1 - 2010/5

N2 - PURPOSE: For clinicians, using opioid therapy for chronic noncancer pain (CNCP) often gives rise to a confl ict between treating their patients' pain and fears of addiction, diversion of medication, or legal action. Consequent stresses on clinical encounters might adversely affect some elements of clinical care. We evaluated a possible association between chronic opioid therapy (COT) for CNCP and receipt of various preventive services. METHODS: We conducted a retrospective cohort study in 7 primary care clinics within the Oregon Rural Practice-based Research Network (ORPRN). Using medical records of 704 patients, aged 35 to 85 years, seen during a 3-year period, we compared the receipt of 4 preventive services between patients on COT for CNCP and patients not on chronic opioid therapy (non-COT). We used multivariate log-binomial regression analyses to estimate the relative risk of receipt of each preventive service. RESULTS: After adjustment for plausible confounders, we found that patients using COT had a statistically signifi cantly lower relative risk (RR) of receipt of cervical cancer screening (RR = 0.60; 95% confi dence interval [CI], 0.47-0.76) and colorectal cancer screening (RR = 0.42; 95% CI, 0.22-0.80) when compared with non-COT patients. The RR was reduced, without statistical signifi cance, for lipid screening (RR = 0.77; 95% CI, 0.54-1.10), and not notably reduced for smoking cessation counseling (RR = 0.95; 95% CI, 0.78-1.15). CONCLUSIONS: Patients using COT for CNCP were less likely to receive some preventive services. Research is needed to better understand barriers to and improved methods for providing preventive services for these patients.

AB - PURPOSE: For clinicians, using opioid therapy for chronic noncancer pain (CNCP) often gives rise to a confl ict between treating their patients' pain and fears of addiction, diversion of medication, or legal action. Consequent stresses on clinical encounters might adversely affect some elements of clinical care. We evaluated a possible association between chronic opioid therapy (COT) for CNCP and receipt of various preventive services. METHODS: We conducted a retrospective cohort study in 7 primary care clinics within the Oregon Rural Practice-based Research Network (ORPRN). Using medical records of 704 patients, aged 35 to 85 years, seen during a 3-year period, we compared the receipt of 4 preventive services between patients on COT for CNCP and patients not on chronic opioid therapy (non-COT). We used multivariate log-binomial regression analyses to estimate the relative risk of receipt of each preventive service. RESULTS: After adjustment for plausible confounders, we found that patients using COT had a statistically signifi cantly lower relative risk (RR) of receipt of cervical cancer screening (RR = 0.60; 95% confi dence interval [CI], 0.47-0.76) and colorectal cancer screening (RR = 0.42; 95% CI, 0.22-0.80) when compared with non-COT patients. The RR was reduced, without statistical signifi cance, for lipid screening (RR = 0.77; 95% CI, 0.54-1.10), and not notably reduced for smoking cessation counseling (RR = 0.95; 95% CI, 0.78-1.15). CONCLUSIONS: Patients using COT for CNCP were less likely to receive some preventive services. Research is needed to better understand barriers to and improved methods for providing preventive services for these patients.

KW - Chronic pain

KW - Family practice

KW - Health disparities

KW - Health services research

KW - Opioid therapy

KW - Practice-based research

KW - Preventive services

KW - Primary health care

KW - Rural health care

UR - http://www.scopus.com/inward/record.url?scp=77952490784&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77952490784&partnerID=8YFLogxK

U2 - 10.1370/afm.1114

DO - 10.1370/afm.1114

M3 - Article

C2 - 20458107

AN - SCOPUS:77952490784

VL - 8

SP - 237

EP - 244

JO - Annals of Family Medicine

JF - Annals of Family Medicine

SN - 1544-1709

IS - 3

ER -