“Better quality of care may reduce the risk of death for patients who are prescribed opioid painkillers for chronic pain, say Yale researchers. Their study, published Feb. 4 in the Journal of General Internal Medicine, offers evidence that supports recommendations from clinical practice guidelines encouraging physicians to engage patients with mental health services and substance abuse treatment, as well as to avoid co-prescriptions for sedatives.
To investigate the impact of “guideline-concordant” care — care that adheres to the guidelines — a Yale-led team of researchers reviewed and analyzed records of more than 17,000 Veterans Affairs patients treated with long-term opioid therapy for pain. These patients initiated opioid therapy between 2000 and 2010, and outcomes were assessed one year later.
The researchers found that after one year more than 1,000, or 6%, of patients had died but that guideline-concordant care had an impact. “Those who received mental health services, substance abuse treatment, and physical rehabilitation were less likely to die within the first six months of starting opioids,” said Julie R. Gaither, postdoctoral fellow at Yale School of Medicine and the study’s first author. “Patients who received mental health care were 50% less likely to die,” Gaither noted.
However, patients who received benzodiazepines, or sedatives, in addition to opioids were approximately 1.5 times more likely to die, and patients who did not receive treatment for substance abuse were 2.5 times more likely to die.
Source: Yale University – February 4, 2016