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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| Published in: | Scientific reports Vol. 15; no. 1; pp. 31924 - 7 |
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| Main Authors: | , , , , , , |
| Format: | Journal Article |
| Language: | English |
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Nature Publishing Group UK
29.08.2025
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| ISSN: | 2045-2322, 2045-2322 |
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| Abstract | 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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| AbstractList | 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. 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. Abstract 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. 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.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. |
| ArticleNumber | 31924 |
| Author | Ford, Morgan A. Nguyen, Anh P. Narwaney, Komal J. McClure, David L. Rinehart, Deborah J. Glanz, Jason M. Binswanger, Ingrid A. |
| Author_xml | – sequence: 1 givenname: David L. surname: McClure fullname: McClure, David L. email: mcclure.david@marshfieldresearch.org organization: Marshfield Clinic Research Institute, Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Institute – sequence: 2 givenname: Ingrid A. surname: Binswanger fullname: Binswanger, Ingrid A. organization: Institute for Health Research, Kaiser Permanente Colorado, Colorado Permanente Medical Group, Division of General Internal Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Department of Health System Sciences, Kaiser Permanente Bernard J. Tyson School of Medicine – sequence: 3 givenname: Komal J. surname: Narwaney fullname: Narwaney, Komal J. organization: Institute for Health Research, Kaiser Permanente Colorado – sequence: 4 givenname: Morgan A. surname: Ford fullname: Ford, Morgan A. organization: Institute for Health Research, Kaiser Permanente Colorado – sequence: 5 givenname: Anh P. surname: Nguyen fullname: Nguyen, Anh P. organization: Institute for Health Research, Kaiser Permanente Colorado – sequence: 6 givenname: Deborah J. surname: Rinehart fullname: Rinehart, Deborah J. organization: Division of General Internal Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Center for Health Systems Research, Office of Research, Denver Health and Hospital Authority – sequence: 7 givenname: Jason M. surname: Glanz fullname: Glanz, Jason M. organization: Institute for Health Research, Kaiser Permanente Colorado, Colorado School of Public Health |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/40883563$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.15585/mmwr.mm6736a2 10.1016/j.vaccine.2017.01.027 10.7326/M16-2367 10.7326/M19-3602 10.1056/NEJMp2211040 10.1016/j.bja.2019.03.023 10.1177/08897077231186216 10.1001/jamanetworkopen.2022.34671 10.1016/j.mcna.2015.08.011 10.15585/mmwr.rr6501e1 10.1097/j.pain.0000000000002291 10.23970/AHRQEPCCER227 10.2147/JPR.S155444 10.1097/j.pain.0000000000003529 |
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| Title | Patterns of long-term opioid therapy with prior nonpharmacologic pain management utilization |
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