Effect of an opioid management program for Colorado workers’ compensation providers on adherence to treatment guidelines for chronic pain

Objective

The aim of this study was to examine adherence of state guidelines for Colorado workers’ compensation physicians/providers treating individuals as injured workers with chronic pain after initiation of an opioid management program and provider incentives.

Methods

A retrospective cohort of chronic, non‐cancer pain claims was constructed from the Colorado's workers’ compensation database. Adherence to treatment guidelines and opioid prescribing practices were evaluated during implementation of a new billing code to incentivize adherence.

Results

Overall, less than 33% of claims showed evidence of opioid management. Comprehensive opioid management was observed in only 4.4% of claims. In 2010, after implementing the new billing code, the ratio of long acting opioids to short acting opioids decreased from 0.2 to 0.13; returning to 0.2 in one year. Similarly, morphine equivalent doses declined for a short period.

Conclusions

Incentivizing physicians to adhere to chronic pain management guidelines only temporarily improves prescribing practices.

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