A research team at the University of Washington School of Public Health will receive a $5 million funding award from the Patient-Centered Outcomes Research Institute (PCORI) to study strategies to prevent unsafe opioid prescribing in workers’ compensation programs in two states.
Gary Franklin, research professor in the Department of Environmental & Occupational Health Sciences, leads the team.
Researchers will leverage a natural experiment to compare the effectiveness of two distinct opioid review programs: Washington state’s prior authorization procedures and Ohio’s retrospective review of opioid prescriptions. Prior authorization requires physicians to get approval from health insurance companies before prescribing medicine, while retrospective reviews are done after services have been provided.
Both approaches have proven effective in decreasing unsafe opioid prescribing. However, more research is needed to understand the impact on patients’ health and well-being. The focus will be on opioid prescribing for common musculoskeletal conditions, such as low back and neck pain, which account for the largest burden of disability in the United States.
Researchers say their findings could influence the uptake of such strategies nationwide.
“One of the key strategic directions to reverse the opioid epidemic is to prevent unsafe opioid prescribing and the transition to ineffective chronic opioid use in common, acute pain conditions,” said Franklin, who is also medical director of the Washington State Department of Labor and Industries. “This population-based project in Washington and Ohio will teach us a great deal about how best to accomplish this goal.”
Both Washington and Ohio have regulatory authority over health care delivery to all injured workers. They are also the two largest states with an exclusive State Fund, which means private workers’ compensation insurance companies do not operate in these states. What’s more, both have initiated distinct opioid review programs consistent with prescribing guidelines.
This study is among 16 projects recently approved for PCORI funding totaling $85 million to improve care and outcomes for conditions that impose high burdens on patients, caregivers and the health care system. It is also the latest study in PCORI’s portfolio of patient-centered comparative clinical effectiveness studies on substance use disorders and pain management. Researchers plan to examine each state program’s patient-centered outcomes, including pain, quality of life and return to work, as well as the presence of opioid use disorder and work disability.
“This project was selected for PCORI funding for its potential to fill an important gap in our understanding of unsafe opioid prescribing and to give people living with pain useful information to help them weigh the effectiveness and safety of their care options,” said PCORI Executive Director Joe Selby. “We look forward to following the study’s progress and working with the UW School of Public Health to share the results.”
The award is approved pending completion of a business and programmatic review by PCORI staff and issuance of a formal award contract. PCORI is an independent, nonprofit organization authorized by Congress in 2010. Its mission is to fund research that will provide patients, their caregivers and clinicians with the evidence-based information needed to make better-informed healthcare decisions.
(By Ashlie Chandler, UW School of Public Health)