Pain Agreements and Healthcare Utilization in a Veterans Affairs Primary Care Population: A Retrospective Chart Review

Pain and Therapy
Cynthia KayJoanne Bernstein

Abstract

The prevalence of chronic pain is enormous. In America, the management of chronic pain and opioids remains a critical focus. Guidelines recommend pain agreements as part of the management of chronic pain and opioids; however, evidence of improvement in patient outcomes is lacking. An aspect of patient outcome includes utilization of healthcare resources, such as emergency department visits and hospitalizations. It remains uncertain whether the use of pain agreements lessens healthcare utilization. Retrospective chart review of a Midwest Veterans Affairs primary care clinic. Subjects were veterans on chronic opioids between 1 April 2014 and 1 April 2015. Outcome measures included emergency department visits, hospitalizations, clinic visits, telephone triage, telephone/secure messages, and nurse visits. The charts of 635 veterans on chronic opioids were reviewed. Of these, 295 were on a pain agreement. There were no significant differences in demographics, medical, or psychiatric diagnoses between patients with and without pain agreements. There were significant differences in opioid schedule and number of opioids based on pain agreement (p < 0.01). Patients on pain agreements did not utilize healthcare resources less than patien...Continue Reading

References

Aug 10, 1999·Journal of Pain and Symptom Management·S M FishmanD Borsook
Oct 16, 1999·Lancet·A M ElliottW A Chambers
Mar 28, 2006·The American Journal of Medicine·Robert M ArnoldDeborah Seltzer
Jan 9, 2008·The Clinical Journal of Pain·Mark J FaganMichael D Stein
Apr 10, 2014·Journal of Opioid Management·Joanna L StarrelsChinazo O Cunningham
Mar 16, 2016·JAMA : the Journal of the American Medical Association·Deborah DowellRoger Chou
Mar 25, 2017·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Cynthia KayJoanne Bernstein

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Citations

Jun 27, 2021·Journal of General Internal Medicine·Christopher L RowePhillip Coffin

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