{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T12:44:22Z","timestamp":1747226662661,"version":"3.40.5"},"reference-count":18,"publisher":"Weston Medical Publishing","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J of Opioid Management"],"abstract":"<jats:p>Objective: This analysis seeks to understand variables within our institution that impact pain management agreement (PMA) utilization for chronic noncancer pain (CNCP).\r\nDesign: Retrospective chart review.\r\nSetting: Public academic medical center.\r\nPatients: Adults prescribed an opioid for CNCP between July 2020 and October 2020.\r\nMain outcome measure: We assessed the association between patient demographics, prescription factors, and prescriber factors with the presence of a PMA. Unadjusted rates and chi-square tests were generated for each predictor. Additionally, we performed two multivariable logistic regressions: one including all variables and another utilizing a stepwise forward variable selection process to further understand the relationships between predictors and the presence of a PMA.\r\nResults: 49.7 percent of patients who received an opioid for CNCP had a PMA on file. One significant predictor of the presence of PMA was prescriber specialty with anesthesia\/pain medicine, demonstrating 88 percent compliance. Compared to anesthesia\/pain medicine, patients receiving opioids from internal medicine had an odds ratio (OR) of 0.155 (95 percent confidence interval (CI), 0.109-0.220), while patients receiving opioids from family medicine had an OR of 0.122 (95 percent CI, 0.090-0.167). Additionally, patients who received schedule II opioids (as opposed to schedule III\/IV opioids), patients with multiple opioid fills in 3 months, middle aged patients, and Black patients were more likely to have a PMA.\r\nConclusions: Compliance with PMA within our institution was only 49 percent despite an existing state law mandating use. Our analysis suggests quality improvement interventions should target patients on schedule III\/IV opioids who receive their prescriptions from primary care providers.<\/jats:p>","DOI":"10.5055\/jom.0816","type":"journal-article","created":{"date-parts":[[2023,11,20]],"date-time":"2023-11-20T21:43:31Z","timestamp":1700516611000},"page":"423-431","source":"Crossref","is-referenced-by-count":0,"title":["Factors that impact initiation of pain management agreements for patients on chronic opioid therapy"],"prefix":"10.5055","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6458-2420","authenticated-orcid":false,"given":"Katherine","family":"Gonzalez","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5108-8637","authenticated-orcid":false,"given":"Alejandro","family":"Villasante-Tezanos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5339-0087","authenticated-orcid":false,"given":"Gulshan","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7725-8574","authenticated-orcid":false,"given":"Gulshan","family":"Doulatram","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2683-2185","authenticated-orcid":false,"given":"Stephen B.","family":"Williams","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1975-4008","authenticated-orcid":false,"given":"Erin L.","family":"Hommel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3008","published-online":{"date-parts":[[2023,11,20]]},"reference":[{"key":"87428","unstructured":"Centers for Medicare and Medicaid Services: CMS roadmap strategy to fight the opioid crisis. Available at https:\/\/www.cms.gov\/About-CMS\/Agency-Information\/Emergency\/Downloads\/Opioid-epidemic-roadmap.pdf. Accessed February 6, 2022."},{"key":"87429","doi-asserted-by":"crossref","unstructured":"Chou R, Fanciullo GJ, Fine PG, et al.: Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain. J Pain. 2009; 10: 113-130.e22.","DOI":"10.1016\/j.jpain.2008.10.008"},{"key":"87430","doi-asserted-by":"crossref","unstructured":"Dowell D, Haegerich TM, Chou R: CDC guideline for prescribing opioids for chronic pain\u2014United States, 2016. JAMA. 2016; 315: 1624-1645.","DOI":"10.1001\/jama.2016.1464"},{"key":"87431","unstructured":"Federation of State Medical Boards: Guidelines for the chronic use of opioid analgesics. Available at https:\/\/www.fsmb.org\/siteassets\/advocacy\/policies\/opioid_guidelines_as_adopted_april-2017_final.pdf. Accessed February 6, 2022."},{"key":"87432","doi-asserted-by":"crossref","unstructured":"Teitelbaum J, Rosenbaum S: Gonzales v. Oregon: Implications for public health policy and practice. Public Health Rep. 2007; 122: 122-124.","DOI":"10.1177\/003335490712200117"},{"key":"87433","unstructured":"Federation of State Medical Boards: Pain management policies board by board overview. Available at https:\/\/www.fsmb.org\/siteassets\/advocacy\/key-issues\/pain-management-by-state.pdf. Accessed February 6, 2022."},{"key":"87434","unstructured":"National Alliance for Model State Drug Laws: Overview of state pain management and prescribing policies. Available at https:\/\/namsdl.org\/wp-content\/uploads\/Overview-of-State-Pain-Management-and-Prescribing-Policies-1.pdf. Accessed February 6, 2022."},{"key":"87435","unstructured":"Texas Administrative Code: Rule 1703 minimum requirements for the treatment of chronic pain. Available at https:\/\/texreg.sos.state.tx.us\/public\/readtac$ext.TacPage?sl=R&app=9&p_dir=&p_rloc=&p_tloc=&p_ploc=&pg=1&p_tac=&ti=22&pt=9&ch=170&rl=3. Accessed February 6, 2022."},{"key":"87436","doi-asserted-by":"crossref","unstructured":"Wong R, Carroll W, Muttreja A, et al.: Improving opioid management and resource utilization in an internal medicine residency clinic: A before-after study over two plan-do-study-act cycles. Pain Med. 2019; 20: 1919-1924.","DOI":"10.1093\/pm\/pny239"},{"key":"87437","doi-asserted-by":"crossref","unstructured":"Kay C, Wozniak E, Koller S, et al.: Adherence to chronic opioid therapy prescribing guidelines in a primary care clinic. J Opioid Manag. 2016; 12: 333-345.","DOI":"10.5055\/jom.2016.0350"},{"key":"87438","doi-asserted-by":"crossref","unstructured":"Kay C, Wozniak E, Ching A, et al.: Pain agreements and healthcare utilization in a veterans affairs primary care population: A retrospective chart review. Pain Ther. 2018; 7: 121-126.","DOI":"10.1007\/s40122-018-0098-5"},{"key":"87439","unstructured":"Texas Administrative Code: Prescription of controlled substances pain management definitions rule 1702. Available at https:\/\/texreg.sos.state.tx.us\/public\/readtac$ext.TacPage?sl=R&app=9&p_dir=&p_rloc=&p_tloc=&p_ploc=&pg=1&p_tac=&ti=22&pt=9&ch=170&rl=2. Accessed February 6, 2022."},{"key":"87440","unstructured":"United States Drug Enforcement Administration: Drug scheduling. Available at https:\/\/www.dea.gov\/drug-information\/drug-scheduling. Accessed February 6, 2022."},{"key":"87441","unstructured":"Oregon Pain Guidance: Opioid conversion calculator. Available at https:\/\/www.oregonpainguidance.org\/opioidmedcalculator\/. Accessed February 6, 2022."},{"key":"87442","unstructured":"Substance Abuse and Mental Health Services Administration: Key substance use and mental health indicators in the United States: Results from the 2017 National Survey on Drug Use and Health. Available at https:\/\/www.samhsa.gov\/data\/report\/2017-nsduh-annual-national-report. Accessed February 6, 2022."},{"key":"87443","doi-asserted-by":"crossref","unstructured":"Breuer B, Cruciani R, Portenoy RK: Pain management by primary care physicians, pain physicians, chiropractors, and acupuncturists: A national survey. South Med J. 2010; 103: 738-747.","DOI":"10.1097\/SMJ.0b013e3181e74ede"},{"key":"87444","doi-asserted-by":"crossref","unstructured":"Fishman SM, Mahajan G, Jung SW, et al.: The trilateral opioid contract bridging the pain clinic and the primary care physician through the opioid contract. J Pain Symptom Manage. 2002; 24: 335-344.","DOI":"10.1016\/S0885-3924(02)00486-4"},{"key":"87445","doi-asserted-by":"crossref","unstructured":"Laks J, Alford DP, Patel K, et al.: A national survey on patient provider agreements when prescribing opioids for chronic pain. J Gen Intern Med. 2021; 36: 600-605.","DOI":"10.1007\/s11606-020-06364-2"}],"container-title":["Journal of Opioid Management"],"original-title":[],"link":[{"URL":"https:\/\/wmpllc.org\/ojs\/index.php\/jom\/article\/download\/3538\/3829","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/wmpllc.org\/ojs\/index.php\/jom\/article\/download\/3538\/3829","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,20]],"date-time":"2023-11-20T21:44:06Z","timestamp":1700516646000},"score":1,"resource":{"primary":{"URL":"https:\/\/wmpllc.org\/ojs\/index.php\/jom\/article\/view\/3538"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,20]]},"references-count":18,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2023,11,20]]}},"URL":"https:\/\/doi.org\/10.5055\/jom.0816","relation":{},"ISSN":["1551-7489","1551-7489"],"issn-type":[{"type":"electronic","value":"1551-7489"},{"type":"print","value":"1551-7489"}],"subject":[],"published":{"date-parts":[[2023,11,20]]}}}