| Year Funded: 2012 | Budget: | Funding Agency: Canadian Institutes of Health Research (CIHR), Workplace Safety and Insurance Board of Ontario, WorkSafeBC |
|---|---|---|
| Title: | Early Opioid Prescriptions for Work-Related Musculoskeletal Disorders of the Low Back: Understanding Utilization Patterns, Determinants, and Impact on Work Disability (IWH Project 2170) | |
| Category: | Compensation, Disability Management and Return to Work | |
| Subcategory: | Compensation, Disability Management and Return to Work | |
| Keywords: | opioid medication, chronic pain, work disability | |
| Link to research website: | www.iwh.on.ca | |
Issue:
Increasing use of prescription opioids among workers with musculoskeletal disorders, such as back pain, has become a significant source of concern for workers’ compensation systems across North America. Recent data suggest opioids are being prescribed increasingly earlier after filing a workers’ compensation claim for work-related low back pain (WRLBP) and that these early opioid prescriptions are leading to prolonged work disability. However, a number of methodological limitations are present in these studies that cast doubt on the validity of their conclusions.
Objectives:
To describe pre-claim and post-claim patterns of LBP-related health care and opioid, non-opioid, and adjuvant analgesic prescriptions and their associated factors.
To describe whether opioid, non-opioid, and adjuvant analgesic prescription patterns have changed.
To assess the validity of billing data on opioid, non-opioid, and adjuvant analgesic prescriptions.
To describe post-claim opioid prescriptions patterns suggestive of possible opioid misuse or problematic prescribing and describe whether these patterns have changed since 1998.
To determine whether opioid analgesics prescribed to workers within the first eight weeks of filing a new workers’ compensation lost-time claim for WRLBP are associated with future work disability compared to NSAIDs and muscle relaxants.
To determine whether specific opioid prescription characteristics are associated with future work disability among workers who receive at least one opioid prescription in first eight weeks of claim.
Anticipated Results:
The findings will improve our understanding of whether opioids provided early in the course of a claim are associated with work disability. This study will generate new knowledge on LBP-related health care leading up a claim, analgesic prescribing patterns, and opioid prescription patterns suggestive of misuse or problematic prescribing. These findings will be fundamental to informing new and existing policies in workers’ compensation systems, as well as for physicians. It will also have implications for injured workers seeking safe and effective pain management options.
Investigators:
Sheilah Hogg-Johnson, Nancy Carnide, Andrea Furlan, Hyunmi Lee, Pierre Côté, Mieke Koehoorn (Institute for Work & Health, Ontario University Institute of Technology, University of British Columbia )
