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Impact of a Graduated Approach on Opioid Initiation and Loss of Earnings Following Workplace Injury: A time series analysis.

Gomes, Tara MHSc, PhD; Duesburry, June MScN, MBA; Theriault, Marc-Erick MSc; Bain, Donna PhD; Singh, Samantha BSc; Martins, Diana MSc; Juurlink, David MD PhD
Journal of Occupational & Environmental Medicine: Post Acceptance: October 3, 2017
doi: 10.1097/JOM.0000000000001187
Original Article: PDF Only

Objective: To explore the impact of the Ontario Workplace Safety & Insurance Board's (WSIB's) graduated approach to opioid management on opioid prescribing and disability claim duration.

Methods: We studied patterns of opioid use and disability claim duration among Ontarians who received benefits through the WSIB between 2002 and 2013. We used interventional time series analysis to assess the impact of the WSIB graduated formulary on these trends.

Results: After the introduction of the graduated formulary, initiation of short- and long-acting opioids fell significantly (p-value < 0.0001). We also observed a shift toward the use of short-acting opioids alone (p < 0.0001). Although disability claim duration declined, this could not be ascribed to the intervention (p = 0.18).

Conclusions: A graduated opioid formulary may be an effective tool for providers to promote more appropriate opioid prescribing.

Copyright (C) 2017 by the American College of Occupational and Environmental Medicine