Table 2.
Profile-guided opioid-related interventions resulted in significant decreases in patient pain
| Opioid-related intervention | Profile risk categorya (% in category)
|
Totala (overall %) | Pain NRS follow-up versus baseline
|
|||
|---|---|---|---|---|---|---|
| Low n (%) | Moderate n (%) | High n (%) | Average change | p-value | ||
| Changed selection | 141 (48) | 182 (51) | 23 (52) | 346 (50) | −3.6 | 1.29×10−55 |
| Opioid initiation | 58 (20) | 68 (19) | 5 (11) | 131 (19) | −3.2 | 1.07×10−22 |
| Dose increase | 63 (22) | 61 (17) | 4 (9) | 128 (19) | −3.4 | 1.96×10−21 |
| Dose decrease | 23 (8) | 39 (11) | 5 (11) | 67 (10) | −3.3 | 1.82×10−12 |
| Short acting to long acting | 19 (6) | 10 (3) | 0 (0) | 29 (4) | −2.9 | 1.19×10−5 |
| Long acting to short acting | 11 (4) | 9 (3) | 0 (0) | 20 (3) | −3.4 | 1.31×10−4 |
| Opioid discontinuation | 28 (10) | 42 (12) | 10 (23) | 80 (12) | −4.0 | 4.44×10−14 |
| Switched to non-opioid | 11 (4) | 10 (3) | 2 (5) | 23 (3) | −3.5 | 1.33×10−4 |
| ≥1 interventions | 291 | 356 | 44 | 691 | −3.4 | 3.39×10−108 |
Notes: Physicians used the profile to guide treatment for 2,809 (52%) patients. Of these, physicians made a change in the opioid medication regimen for 691 (24.5%) subjects. All actions except for implementing a non-opioid therapy resulted in a significant decrease in patient pain, as measured by the NRS. Physicians were less likely to initiate opioid therapy or increase dose and more likely to discontinue opioids for high-risk profile patients. The actions of decreasing the prescription dose and implementing a non-opioid therapy did not differ across risk categories.
Column totals add to more than overall if patients were given more than one intervention.
Abbreviation: NRS, numeric rating scale.