Drug Utilization Review and Medical Cost Containment StrategiesPredictive models in our industry show that specific risk factors correlate to the potential for long term opioid use -most notably, patients that smoke and/or have a history of substance abuse.   With increased opioid prescribing linked to trends of misuse and abuse and opioid related overdoses contributing to more deaths annually than vehicular crashes, it begs the question, are risk factors truly being taken into account with the treatment of chronic pain?

Improving Opioid Painkiller Practices

Physicians considering opioid therapy for an injured worker with chronic pain should use a structured approach. There should be a comprehensive evaluation for the cause of pain, assessment for risk of opioid abuse or addiction, detailed treatment history including a review of medical records and routine assessment for safety and effectiveness of the opioid therapy program once in place. A dedicated focus on the patient will allow treating physicians to:

  • Get ahead of the warning signs of drug abuse and addiction.
  • Modify a treatment program based on patient’s recovery.
  • Modify treatment based on the availability of alternative treatments and therapies that may be more effective, and have fewer side effects.
  • Avoid unnecessary or inappropriate pharmaceutical and medical treatments in the event there are multiple treating physicians in the picture.

Risks should be acknowledged openly and managed, whenever possible, before prescribing opioids. When continuous opioid therapy for as little as two weeks can produce drug tolerance in some patients, the bottom line is, we need to start thinking more about the injured worker.

ANS Drug Utilization Review

Interventions with prescribers can be instrumental in not only preventing long term opioid use but also improving the quality of life and treatment for patients while also driving down medical costs. At ANS, our approach to drug utilization review includes an extensive review of a patient’s medical history allowing our experts to pinpoint risk factors and other considerations that are all too often overlooked by other medical cost management programs in the industry.

For more information about our medical cost containment strategies contact us today.