Patterns of long-term opioid therapy with prior nonpharmacologic pain management utilization

In 2022, the Centers for Disease Control and Prevention updated opioid prescribing guideline to emphasize use of non-addictive pharmacotherapies or nonpharmacologic procedures in place of or as an aid in starting the lowest feasible opioid dosage. However, the impact of nonpharmacologic pain managem...

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Bibliographic Details
Published in:Scientific reports Vol. 15; no. 1; pp. 31924 - 7
Main Authors: McClure, David L., Binswanger, Ingrid A., Narwaney, Komal J., Ford, Morgan A., Nguyen, Anh P., Rinehart, Deborah J., Glanz, Jason M.
Format: Journal Article
Language:English
Published: London Nature Publishing Group UK 29.08.2025
Nature Publishing Group
Nature Portfolio
Subjects:
692/700/565/1436
692/700/565/411
Acupuncture
Adult
Aged
Analgesics, Opioid - administration & dosage
Analgesics, Opioid - therapeutic use
Chiropractic medicine
Chronic pain
Chronic Pain - drug therapy
Chronic Pain - therapy
Clinical medicine
COVID-19
Dosage
Drug abuse
Drug therapy
Electronic health records
Female
Females
Health care policy
Humanities and Social Sciences
Humans
Long-term opioid therapy
Male
Management
Medicaid
Medicare
Mental health
Methadone
Middle Aged
Morphine
multidisciplinary
Narcotics
Nervous system
Nonpharmacologic pain management
Opioids
Pain management
Pain Management - methods
Patients
Pharmacists
Physical therapy
Practice Patterns, Physicians
Regression analysis
Science
Science (multidisciplinary)
United States > US
Colorado
Long-term opioid therapy
Nonpharmacologic pain management
ISSN:2045-2322, 2045-2322
Online Access:Get full text
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Summary:In 2022, the Centers for Disease Control and Prevention updated opioid prescribing guideline to emphasize use of non-addictive pharmacotherapies or nonpharmacologic procedures in place of or as an aid in starting the lowest feasible opioid dosage. However, the impact of nonpharmacologic pain management utilization on concurrent or subsequent opioid therapy dosing remains unexplored. We described patterns of nonpharmacologic pain management utilization prior to initial dose level in patients starting long-term opioid therapy. Utilizing electronic health data, we created a nonpharmacologic pain management utilization code list and applied it in a pre-existing cohort of patients with chronic pain prescribed long-term opioid therapy (LTOT) from August 2016 through September 2021. Univariate descriptions and bivariate associations of covariates with the initial LTOT mean daily morphine milligram equivalents (MME) categories were described via counts, percentages, and chi-square or Kruskal Wallis tests as appropriate. We also conducted a secondary multivariate regression analysis among patients with at least 12 months of health plan enrollment. There were 7679 patients for analysis with initial mean daily LTOT levels spanning 1 to 90 + MME. Nonpharmacologic therapies for pain management were infrequently utilized among patients starting LTOT and were dose dependent. This novel approach to identifying and categorizing nonpharmacologic therapies may help assess their clinical effectiveness in future studies.
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ISSN:2045-2322
2045-2322
DOI:10.1038/s41598-025-17979-y