Opioid Prescribing: Sometimes Less May Help More

Findings from a recent study conducted at Kaiser Permanente Department of Research and Evaluation conclude that when physicians reduce opioid dosage levels for their patients who are on high-dose opioid therapy for chronic pain, levels of patient satisfaction with care do not suffer. Lead author Adam Sharp, MD, MS, commented “Physicians are often concerned they will receive lower satisfaction scores if they reduce opioids for patients who are accustomed to high opioid doses to manage chronic pain. This study showed that following current recommendations and reducing opioids for chronic pain did not result in lower satisfaction scores.” The study encompassed nearly 2,492 patients who had received high doses of opioids for a minimum of 6 months for pain management between 2009 and 2014. The findings were published last week in The American Journal of Managed Care.

In the study, patient satisfaction scores were compared for patients who underwent opioid dose tapering versus patients who maintained a high dose level. A reduction in opioid dose level was not associated with unfavorable patient satisfaction scores, with 86.4% of patient encounters sustaining favorable satisfaction with their care. Underscoring the importance of the primary care/patient relationship, the study also noted that the chances of maintaining patient satisfaction were greatest when the dose reduction was managed by the primary care physician. Dr. Sharp’s message to patients was that “You should be reassured that your physician wants to follow guidelines designed to improve your health and well-being. At times, your doctor may be helping you most by prescribing less.”

Read a press release about the study findings.

The journal abstract may be read here.

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