Despite the potential for abuse, addiction and overdose, few primary-care physicians are paying adequate attention to those patients taking prescription opioid drugs, according to a new study by researchers at Albert Einstein College of Medicine of Yeshiva University.
The administrative and medical records of more than 1,600 primary-care patients were reviewed for an average of two years while they received regular prescription opioids for chronic, non-cancerous pain. The researchers examined whether patients received urine drug testing, were seen regularly in the office, or received multiple early opioid refills.
The researchers found that only a small rate (8 percent) of patients had undergone urine drug testing. While such testing was more common in patients with a higher risk for opioid misuse, the rate of testing among those high-risk patients remained low (24 percent), according to the study which appears in the March 2 online edition of the Journal of General Internal Medicine.
Only half of those patients were seen regularly in the office, and patients with a higher risk of opioid misuse were not seen more frequently than patients at lower risk. Although 23 percent of all patients had received two or more early opioid refills, the patients with the greater risk for opioid misuse were more likely to receive multiple early refills.
"We were disturbed to find that patients with a drug use disorder were seen less frequently in the office and were prescribed more early refills than patients without these disorders," said lead author Joanna Starrels, MD, assistant professor of medicine at Einstein.