San Diego, CA – WCF Mutual Insurance Company and Mitchell recently published a study about the use of opioids by injured workers in workers’ compensation claims in Utah. The results of the study are especially significant for Utah, a state that ranked seventh in drug poisoning deaths between 2013 and 2015 and has been in the top 10 states for overdoses in the United States for the past 10 years.
The study, entitled “Implementation of an Opioid Guideline Impacts on Opioid Prescriptions, Adverse Outcomes, and an Association with a State Opioid-Related Fatalities,” is published in the Journal of Occupational and Environment Medicine.
Among the many findings about opioid use in Utah among injured workers, the study found that the number of acute claims prescribed opioids dropped by more than 50 percent after implementation of the 18-month program. This decrease represented more than 13,000 fewer opioid pills dispensed to injured workers.
WCF Insurance representatives and Mitchell’s Dr. Mitch Freeman, Pharm.D. and Roger Kartchner co-authored the study of WCF claimants with Andrew Phillips, MD, Matthew Thiese, PhD, and Kurt Hegmann, MD. The study examined the impact of implementing an evidence-based, guidelines-based program on opioid use and abuse in Utah. Among the factors studied were the number of opioid pills prescribed, the time length of prescriptions and outcomes from the changes implemented by WCF and Mitchell.
Opioids in Utah Before Program Implementation
The opioid crisis is apparent in every state, but Utah is particularly affected. Utah was seventh in the United States for drug poisoning deaths between 2013 and 2015. An average of 20.3 people die from prescription opioid overdoses per 100,000 population. In 2014, however, opioids were prescribed to nearly one-third of Utah adults. Workers’ compensation claims were found to be prominent places where people received opioids, which prompted the initiation of WCF and Mitchell’s opioid protocol program.
Study results show that the number of WCF claims with an opioid prescription decreased by 50.2 percent—from 3,061 to 1,665, or from 11.8 percent of claims to 5.9 percent. This equates to a 56.4 percent reduction of opioid pills dispensed versus prescribed, a total of more than 13,000 opioid pills.
The decrease of 13,000 pills equated to approximately 65,502 mg in MED. Additionally, the number of days’ supply prescribed for first-fill opioids, when including denials and partial fills from post-intervention, dropped from 6.1 to 5.7 days (seven percent).
The number of post-intervention claims requiring a second opioid fill was 528—a 60.9 percent decrease from pre-intervention. The researchers suggest this may indicate that shortened duration does not adversely affect recovery, since the injured workers did not require a refill.
Interestingly, the total number of prescriptions, including non-opioid prescriptions, across all claims fell by 30.8 percent, from 18,665 to 12,909. In 2017, Utah implemented policies related to prescribing opioids and monitoring their use. After these policies and the WCF and Mitchell program were implemented in 2017, Utah saw a 19.8 percent decrease in opioid-related fatalities.
About the Study
According to the study, “The opioid program’s goals were to increase adherence to evidence-based recommendations regarding opioid prescriptions, and ultimately to decrease the adverse effects that may result from improper opioid usage. This study’s objective was to analyze and report on the evidence of efficacy of this program on outcome measures.”
The study measured the impact of a newly implemented opioid guidelines program on the first fill of an opioid prescription for acute pain claims by injured workers covered by WCF in Utah. The study tracked these acute pain claims over 36 months, starting on March 1, 2017 (18 months before and 18 months after intervention).
The program followed the American College of Occupational and Environmental Medicine’s (ACOEM) peer-reviewed opioid guidelines and required all first-fill opioid prescriptions for acute injuries to go through utilization review, ensuring that these prescriptions complied with the ACOEM opioid guidelines.
WCF and Mitchell engaged in an extensive education program for providers, patients and other stakeholders to ensure a smooth transition into the program.
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