@article{ref1,
title="Changes in early high-risk opioid prescribing practices after policy interventions in Washington State",
journal="Health services research",
year="2020",
author="Sears, Jeanne M. and Haight, John R. and Fulton-Kehoe, Deborah and Wickizer, Thomas M. and Mai, Jaymie and Franklin, Gary M.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="OBJECTIVE: To test associations between several opioid prescribing policy interventions and changes in early (acute/subacute) high-risk opioid prescribing practices.   DATA SOURCES: Population-based workers' compensation pharmacy billing and claims data, Washington State Department of Labor and Industries (January 2008-June 2015).   STUDY DESIGN: We used interrupted time series analysis to test associations between three policy intervention timepoints and monthly proportions of population-based measures of high-risk, low-risk, and any workers' compensation-related opioid prescribing. We also tested associations between the policy intervention timepoints and five high-risk opioid prescribing indicators among workers prescribed any opioids within 3 months after injury: (a) >7 cumulative (not necessarily consecutive) days' supply of opioids during the acute phase, (b) high-dose opioids, (c) concurrent sedatives, (d) chronic opioids, and (e) a composite high-risk opioid prescribing indicator.   PRINCIPAL FINDINGS: Within 3 months after injury, 9 percent of workers were exposed to high-risk and 12 percent to low-risk workers' compensation-related opioid prescribing; 79 percent filled no workers' compensation-related opioid prescription. Among workers prescribed any early (acute/subacute) opioids, the indicator for >7 days' supply of opioids during the acute phase was present for 30 percent, high-dose opioids for 18 percent, concurrent sedatives for 3 percent, and chronic opioids for 2 percent. Beyond a general shift toward more infrequent and lower-risk workers' compensation-related opioid prescribing, each policy intervention timepoint was significantly associated with reductions in specific acute/subacute high-risk opioid prescribing indicators; each of the four specific high-risk opioid prescribing indicators had significant reductions associated with at least one policy.   CONCLUSIONS: Several state-level opioid prescribing policies were significantly associated with safer workers' compensation-related opioid prescribing practices during the first 3 months after injury (acute/subacute phase), which should in turn reduce transition to chronic opioids and associated negative health outcomes.<p /> <p>Language: en</p>",
language="en",
issn="0017-9124",
doi="10.1111/1475-6773.13564",
url="http://dx.doi.org/10.1111/1475-6773.13564"
}