Opioid Painkillers: Quality Of Care Reduces Risk Of Death In Patients Prescribed These Drugs

First Posted: Feb 04, 2016 10:31 PM EST
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Yale researchers believe that better quality of care could help in reducing the risk of death for patients prescribed opioid painkillers, according to new findings published in the Journal of General Internal Medicine.

Though guidelines provided by the American Pain Society and the American Academy of Pain Medicine are there to help treat patients prescribed painkiller like Oxycontin and Vicodin for periods of 90 days or longer, researchers say they are frequently not followed, with helpful recommendations including patient monitoring (follow-up visits), testing, and multidisciplinary care, mental health services, substance abuse treatment and physical rehabilitation.

"Opioids are addictive, and patients who have substance use disorder are at great risk," said Julie R. Gaither, postdoctoral fellow at Yale School of Medicine and the study's first author, in a news release. "Physicians should manage these patients with addiction specialists and mental heath providers."

To investigate the impact of the guidelines, Researchers analyzed the records of over 17,000 Veterans Affairs patients to treat long-term opioid therapy for pain. The patients initiated opioid therapy between 2000 and 2010, along with the outcomes that were assessed later that year. 

Findings revealed that after one year or more, 1,000 or 6 percent of the patients had died. However, guideline-concordant care had an impact. 

"Those who received mental health services, substance abuse treatment, and physical rehabilitation were less likely to die within the first six months of starting opioids," said Julie R. Gaither, postdoctoral fellow at Yale School of Medicine and the study's first author. "Patients who received mental health care were 50% less likely to die," Gaither noted.

Patients who received benzodiazepines, or sedatives, in addition to opioids were approximately 1.5 times more likely to die. Meanwhile, those who did not receive treatment for substance abuse were about 2.5 times more likely to die, researchers say. However, reseachers found no difference between those who received recommended follow-up visits or urine drug testing. 

"Opioids are addictive, and patients who have substance use disorder are at great risk," said Gaither. "Physicians should manage these patients with addiction specialists and mental heath providers."

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