Table 2.
The Effects of ECHO Pain Clinician Participation on Prescribing of Opioids and Co-prescribing of Opioids and Benzodiazepines
| Theme/variable | Comparison baseline | ECHO Pain baseline | Comparison annual change percentage, P value | ECHO Pain annual change percentage, P value | Interaction P value |
|---|---|---|---|---|---|
| Opioid analgesic prescriptions (Rx) | |||||
| Avg. number of opioid RX/patient/year | 0.86 | 0.31 | − 9.2, P < 0.001 | − 23.0, P < 0.001 | 0.004 |
| Avg. number of opioid RX/opioid user/year | 1.61 | 2.27 | − 0.6, P < 0.001 | − 1.8, P = 0.36 | 0.41 |
| Percent opioid users | 53.56 | 13.69 | − 8.0, P < 0.001 | − 20.2, P < 0.001 | < 0.001 |
| Morphine milligram equivalents (MME) | |||||
| Avg. MME/patient/year | 363.95 | 171.57 | − 7.3, P < 0.001 | − 28.0, P = 0.002 | 0.02 |
| Avg. MME/opioid user/year | 679.53 | 1253.14 | + 1.1, P = 0.30 | − 6.2, P = 0.33 | 0.32 |
| Percent opioid users | 53.56 | 13.69 | − 8.0, P < 0.001 | − 20.2, P < 0.001 | < 0.001 |
| Co-prescribing opioids and benzodiazepines | |||||
| Days of co-Rx/patient/year | 0.54 | 0.36 | − 9.6, P < 0.001 | − 68.9, P < 0.001 | < 0.001 |
| Percent patients who are co-Rx users | 3.26 | 1.22 | − 8.5, P < 0.001 | − 68.9, P < 0.001 | < 0.001 |
| Days of co-RX/opioid user/year | 1.01 | 2.65 | − 1.3, P = 0.41 | − 53.3, P = 0.002 | < 0.001 |
| Percent opioid users who are co-Rx users | 6.09 | 8.92 | − 0.2, P = 0.82 | − 26.6, P = 0.002 | < 0.001 |
Average annual percent change over the study period in comparison and ECHO Pain groups for several outcome measures concerning opioid use (listed in the left column). Average annual change refers to regression slopes per year in the Repeated Measures (RM) ANCOVA analyses; negative slopes indicate decline. Average baseline values (of the outcome variable listed in the corresponding row) are in the second and third columns for comparison and ECHO Pain groups, respectively. The fourth and fifth columns contain the annual % changes (slopes) and P values testing whether there was any change over time within a group. The final column contains the interaction P values testing whether the two slopes for comparison and ECHO Pain groups differ and indicating whether the ECHO Pain intervention was effective