Opioid Use: Case-Control Analyses of Worker’s Compensation Data

Details

• Personal Author:
  Hegmann K ; Hegmann KT ; Ott U ; Ronna BB ; Thiese MS
• Description:
  Objectives: Working-age adults are disproportionately impacted by opioid misuse. Factors associated with opioid misuse in people with workers compensation (WC) claims are not well studied. WC in some states is a "captured" market making it a more efficient site for researching the opioids epidemic. A pilot study was conducted to identify factors associated with opioid use using a large WC insurer's claims in Utah. Methods: This was a case-control study using a large WC insurer's database. We conducted secondary data analyses of a de-identified dataset originally obtained from the WC insurer. Cases were defined as claims with a morphine equivalent dose (MED) ≥50 mg/d in the 30 days after the claim was filed while controls = 0 mg/d. Results: A total of 76 patient's claims (28 cases and 48 controls) were included in the final data analyses. The majority of claimants were male (N = 50, 65.8 percent), worked full time (N = 58, 76.3 percent) and had a mean age of 37.0 +/- 11.4 years. The majority of controls filed medical only claims (N = 40, 83.3 percent) while the majority of cases filed indemnity claims (N = 19, 67.9 percent). Cases were prescribed a mean MED of 126.4 (SD = 93.3) within the first month after filing the claim. Most cases visited > 3 medical providers (N = 13, 46.4 percent) in the first month after filing the claim while the majority of controls only visited one provider (N = 28, 58.3 percent). Remarkably, the mean number of providers visited within the first month for the cases was 3.8, which was 2-fold greater than the control group. Exploratory multivariate analyses showed that cases were 4.6 times more likely to have visited 2-3 medical providers (p = 0.025), and 41.8 times more likely to have visited more than three medical providers (p < 0.001). Cases had 3.6 higher odds of having been prescribed nonsteroidal anti-inflammatory prescription within the first month as compared to controls (p = 0.014). Conclusion: This pilot study found risk factors, some of which may be modifiable. We aim to conduct a large study using existing WC data to create a scoring system that identifies those claimants at higher risk of adverse opioid-related events that may have preventive applications at a systems-level. [Description provided by NIOSH]
• Subjects:
  Delivery Of Health Care Occupational Health Safety Substance-Related Disorders
• Keywords:
  Author Keywords: Opioids Case Control Case Control Studies Medical Care Occupational Health Prescription Drugs Risk Factors Substance Abuse Worker Health Workers Compensation
• ISSN:
  1551-7489
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  OSHA Region 8 ; Utah
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  273-281
• Volume:
  14
• Issue:
  4
• NIOSHTIC Number:
  nn:20068771
• Citation:
  J Opioid Manag 2018 Jul/Aug; 14(4):273-281
• Federal Fiscal Year:
  2018
• Performing Organization:
  University of Utah
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Journal of Opioid Management
• End Date:
  20280630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:7a5fe70e2e2dfed162057aa225c244e980beb2d87ee281b8169aba8877b8b6443d0b44957d93868094ab90eef86a6943c4b9c57ed31e0972dddfaa14165c026b
• Download URL:
  https://stacks.cdc.gov/view/cdc/207353/cdc_207353_DS1.pdf
• File Type:
  [PDF - 5.19 MB ]