STUDY: Patients Who Receive Prescription Opioids Are More Satisfied with Their Care

STUDY: Patients Who Receive Prescription Opioids Are More Satisfied with Their Care

By Staff.

Patients with musculoskeletal conditions who receive prescription opioids are more satisfied with their care than comparable patients who do not receive opioids.

“In the current payment paradigm, reimbursement is partially based on patient satisfaction scores. We sought to understand the relationship between prescription opioid use and satisfaction with care among adults who have musculoskeletal conditions,” lead author, Brian D. Sites, MD, MS, Geisel School of Medicine at Dartmouth, Dartmouth-Hitchcock Medical Center, wrote.

In a study of nationally representative data, 13 percent (2,564) of more than 19,000 patients with musculoskeletal conditions used prescription opioids. Among those who used opioids over time, moderate and heavy use was associated with greater likelihood (55 percent and 43 percent, respectively) of being most satisfied, compared to single or no use of opioids.

Although opioids may be expected to offer patients with musculoskeletal conditions improved pain control, patients taking opioids in this study had more pain and worse health and disability than those taking limited or no opioids, suggesting a more complex picture.

As clinician compensation is increasingly linked to patient satisfaction, and as the United States struggles with an epidemic in opioid use, the authors suggest it is imperative to determine whether improved satisfaction with care is associated with demonstrable health benefits.

Dr. Sites’ study, Prescription Opioid Use and Satisfaction With Care Among Adults With Musculoskeletal Conditions, is published in the American Academy of Family Physicians’ journal, Annals of Family Medicine.

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Denise

Well today as Mr and Mrs Trump talked about giving one BILLION for advertising rehab.making non addicting pain medication Blah! Blah! And there to go on and say how his alocholic mentor told him to never drink! And he never did what kind of analogy is that!! We are being put through hell because he is being fed a bunch of horse [edit]. He failed us on so many levels. I can’t even express my heart aches along with my physical, and emotional pain!for all of us that have had to endure this nightmare. To never hear about those who are induring Chronic Pain. All the effort we put into being heard.

Missy

As a chronic pain sufferer I totally agree that opioids enabled me to live a relatively normal life for the last 15+ years. I was suffering before I took an appropriate opioid and though I still had pain to contend with, it reduced my pain enough to have a life! Now I feel under attack and wonder how far our government is willing to take this? Are they trying to get rid of the chronic pain patients? Last folks, this is what happens when government takes over health care. Everything becomes about cost and not care. They don’t want to pay for the millions on pain meds so here comes the “studies” and “scientific evidence” explaining why this once miracle drug for so many is suddenly killing us all! Thus we have been thrown in together with street drug abusers! If you keep voting for government health care expect more heartache for the ill and the suffering.

Sandy Auriene Sullivan

Larry,
“From my own pain experience, opioid prescription tended to be the option for the doctor that didn’t know what else to do and pretty well wanted me out the door. When I finally got to someone who wanted to try every path, the opioids went away.”

So in YOUR experience [not mine, not yet anyway but one can hope] when you found a cause and way to relieve your pain without pain meds – you no longer needed them?!

*gasp* whodathunk. Fact is we’d all give them up as soon as they figure out a much better way to deal with pain.

Bob S. I’d love such a device that could determine my own bodies management of naturally produced opiates in the brain and if depleted can my body get a more natural form to cope again… It’s at least in the right direction!

Sandy Auriene Sullivan

Musculoskeletal illnesses are so very painful too. Yes, these survey’s are for certain results but we also know those of us who have all over body pain, associated with EDS/Hypermobility w/injuries [and without] end up needing hip replacements at 35 instead of 65+ too.

Not that there aren’t more painful conditions. Just that musculoskeletal is so broad in nature but affects entire body as well as the joints, spine as to be up there with the best of them.

Sandy Auriene Sullivan

Shocked!! [sarcasm] of course they’re more satisfied with their care! Those who get treatment + meds and options for ‘alternatives’ be it kratom or medical marijuana [which I finally applied for here in Florida, they do examine you and do not just rubber-stamp in my experience] without losing their opiates in the process?

Will *naturally* be more satisfied; they’re receiving more rounded care.

Too bad the CDC lacked this information. *sarcasm*

Kathy C

Those Patient Satisfaction Surveys are designed to keep the responses very narrow, and to obscure the facts. They mostly focus on how nice the staff was. There is no way to really describe the patient experience or capture any meaningful information, by design. These Surveys are very carefully written, with every question gone over by Industry Experts. They are designed to mislead and offer no insight into much of anything. One point made in the Article, is that there might be no correlation between patient satisfaction and healthcare outcomes. I know a lot of people who are happy when they get misdiagnosed or told what they want to hear by a Doctor. I know several people who are dead now, who were relieved when their Doctors told them they were fine, even though they had misdiagnosed their first indications of cancer.
The Medical Industry pushed for Patient Satisfaction Surveys to replace factual information about all aspects of Healthcare. It is much easier to get Patients to believe they are satisfied than to provide Facts, Data or Statistics. It is really telling that they can’t use the ICD -10 Codes to glean any information either. That is by design too.

Cat

Comment part 2:

I forgot to mention I haven’t had the flu in over 10 years.

Cat

Opioid statistics are being manipulated to match so many “studies” that ultimately the studies are being rendered useless. There is nothing right about what is being perpetrated on legitimate chronic pain patients. As an aside, thanks to having to go to the clinic where my pain doctor is, I get exposed to the flu every 30 days. I take immunosuppressant drugs. I have always avoided the clinic during flu season but this year I have a very bad case of flu, and now so does my fiancé who has COPD. I imagine this has been a recurring event this flu season.

Lance

There seems to be 1 glaring reality that the “narcotic debates” tend to overlook, and that is, if narcotics DIDN’T WORK for pain, there would be no narcotic epidemic. Obviously, right off the bat I appear to be a drug-seeker, but the truth is that I’m living with a number of chronic pain conditions. I’ve had fibromyalgia for 9&1/2 years now; have no right rotator cuff, both knees that should be replaced, a fractured skull, and 2 herniated disks. And those are just the tip of the iceberg for me. I was on daily narcotics for 7 years up until June 2016. Since then I’ve tried everything except yoga for my pain. I’m basically miserable every minute of everyday from the pain and fatigue that comes with it. I will admit the narcotics did not take away all my pain, but at least gave me enough relief everyday to function as a normal human being.
So the next time someone suggests that they don’t work or help with chronic pain, please at least take into consideration every possibility.

Jill

LarryK, I was confused by your post. As a part of the older generation I don’t recall any Dr. handing out bags of opiods. And I think if we did a survey almost all pain patients patiently went through a long process before accepting opiods as their best option. I myself had over a dozen types of injections, and enough Nsaids to give me an esophageal ulcer. Of the two options you said we’re not band aids, you couldn’t take one and the other is controversial. Even back as far as forty years ago, opiods were considered strong medicine not to be taken lightly. But when you’re in constant pain, you want what helps.

Lex Feldman

I’m 38 and unable to get double knee replacements I also have lumbar and neck fusion among many other chronic pain issues. I always hear how they wanna say they are worried about my future health. First off let that be my problem, number 2 I don’t care about my future health my time for enjoyment is extremely limited so just let me live now. Prior to the crackdown on pills I did a tremendous amount off stuff when I was “overprescribed” now with a simple 3 15mg Oxycodone a day. I haven’t done much of anything for the last 4 years. My last sexual encounter was 4-5 years ago and my back was killing me. I don’t even try to date anyone because I can’t work and I just can’t do the fun beginning date stuff. Also my back is gonna hurt unless we can get pain medicine back to s standard. Titration method is just fine for the very few that need it like me. I don’t think simple 2mm bulge disk is reason for high opioid use or any at all

Notasheep

As Rachel stated, the patients prescribed narcotics likely had more severe injuries. This is NOT a scientific, valid study without those variables accounted for. I am ever fricken tired of reading politically correct studies with no real value except as fodder for an uninformed, publicity machine feeding the sheep herd.

Kelly

I am sick of the judgement that opiods are bad. Yes, its hard on your body and mind overtime and you have to be careful or they can be more harmful if u don’t keep following the DR’s instructions. Like dealing with depression and thinking one more and I will feel better. That being said my whole Lumbar is fused and nothing helps but opiods. I had to finally tell my DR about it and with anti depressants I am able to manage my pain and depression. You have to be honest with your caregivers and find you can still have quality of life. Can’t play sports anymore but I can play with my dogs and keep the house clean.

Kevin Jelley

“Among those who used opioids over time, moderate and heavy use was associated with greater likelihood (55 percent and 43 percent, respectively) of being most satisfied, compared to single or no use of opioids.”

This is big. Really Big. They report that those whose opioid use was moderate to heavy were the most satisfied. More satisfied than those who did not use opioids, or only used opioids for a short period of time. What it says is that opioids do work for chronic pain. This has been my personal experience.

So when a physician tells you that opioids do not work for chronic pain, cite this study involving 19,000 participants, and published in the “Annals of Family Medicine,” and ask him or her to refute it.

Kevin

Roberta Glick

Thank you for your article. As a chronic pain patient who is able to get out of bed only because of an opioid, I am beyond outraged at the stubborn refusal of those who comprise committees who determine what pain us/isn’t. What physicians may/ may not prescribe. We are barraged with biased, value- laden rules, regulations, etc. in the face of evidence to the contrary. So thank you.

Again, we find that opioids help chronic pain sufferers cope with their situation and enable us to function. However, the media continues to report on the potential negative aspects of opioid use. We continue to read of the Opioid epidemic, and as a result face daily battles to have insurance coverage necessary meds. NOTE: I said meds, not DRUGS, which promulgates the negative. It does not differentiate chronic pain patients from the general population. Funny, we hear only negatives about opioids for anyone while at the same time medications like Cymbalta, Lyrica, neurontin are touted for .everything from pain through depression. Insurance covers even off label use. BUT we don’t hear about extremely negative side effects, difficulties when trying to discontinue, or even about ongoing class action suits against the developers of Cymbalta for failure to disclose information.

Ibin

I can give at least one….demonstrable testinomy of real benefit of opiod medication, and I feel that many millions, hundreds of thousands? of patients are being badly affcted just like me and my family. After years of corrective spine surgery, healing time, money evaporation, the surgeons claim “success” at their corrective surgery yet I am still, in severe pain, 24/7 decades later. Disabling continuous pain. WITH opioid medication to dull the pain enough to remian active I have been able to keep myself employed for……23 years until the first of 2017 when the CDC “policy” became enforced by the DEA. It does not seem to matter what the negative issues that arrived with the unilateral dosage of medication caused. It does not matter that appropriate documentation has been kept by our providers of medication as to the evident benefits of in excess of the CDC “policy” reccomendation, It does not even matter of the factual reported suicide of the patients successfully “were” treated with sufficient opioid medication and the result of the mandated reduction of millions? of patients to the now CDC “policy”, and furthermore the various advocate associations AND patients asking our elect and appointed to please take notice of the harm versus benefit that the “policy” is having on legitimate patients. Our providers know the results of adequate dosage in their patients and they know the “joneses” and they are usually scrubbed from prescribing. Drug abuse is a fact but, prescribed medication sanctioning does not appear to be adiding in the desired result of lessened overdoses.Drug ABUSE can not be effectively addressed by the increased disabling of patients with verirfied, legitimate, known pain generating disease and injury.The misuse and abuse of prescribed opioid medication in my opinion is NOT by the patients because with legitimate lifetme, incurable pain, we have, or we ARE being reposnsible patients and have no other resource to adequately manage pain except….through our physicians I am not saying that drug abuse can not be curbed but, it will never be stopped. I do not have the answer for drug abuse but, I do know what the answer is not. A unilateral maximum dosage of realistically enabling medication monitored monthly or bi-monthly is a good way to fairly accurately monitor a patients body reaction to opioid medication and the successf or harm from opioid medication prescribing. Current Dot/Gov “policy” is purely asiine, harmful to not only physical ability, but, is also etrimental and psychological health and sit is NOT being addressed quick enough due to Dot/Gov beaurocracy. That is the way it is. Underlying profit potentials also play a major, mabne the most influential force behind the asinine reduction of of medication to those of us, our veterans and civilians alike who HAVE well documented records of a more enabled life physically and emotionally yet Dot/Gov “knows best”. A more patriotic citizen you will have a difficult time finding than this writer. I “volunteered” my safety as a community firefighter for 14 years with NO… Read more »

Mark

My experience has been that even if you are in severe chronic pain the Doctors I’ve seen do not want to just give out prescriptions. I had to go through innumerable types of injections and treatments, not just once but 3 or 4 times.
It was only then was I given opioids. And Ithen I had to go to a Pain Management facility where controls are kept on the meds with frequent counts and urinalysis. I was only satisfied with my treatment because finally I had less pain and was able to participate in life!

Bob Schubring

100% of patients receive endogenous opioids. 30 years of repeated Government studies have proven this fact repeatedly, beyond the shadow of any possible doubt.

Yet speaking of this, outside the narrow community of scientists, and discussing it in laypeople’s language, frightens Government bureaucrats.

Democratic institutions can not function, when the majority of people are excluded from becoming fully informed. We’re witnessing the effects on our healthcare system, as knowledge is acquired but no one puts it to use.

It is absurd to discuss patients’ opioid exposure, while ignoring the opioids they secrete in their own bodies. Until we begin recognizing that a deficiency of the nutrients people need to make their own endogenous opioids, causes pain to worsen, we’re not going to make any sense out of the reason why people get pain and need to have opioids administered to them.

Today almost every diabetes patient carries around a Blood Glucose Monitor. The patient pokes herself with it, draws a drop of blood, measures her glucose level, and takes corrective action. If her insulin level is too low, she injects herself with additional insulin, supplementing what her pancreas naturally makes.

Because nobody’s doing the equivalent, with the substances we use to make endogenous opioids, everyone is confused about the symptoms of people who complain of pain.

Oh so very true. I had to retire early because of the misuse of opioid pain medications and therefore the government reductions that only succeeded to reduce our incomes and not slow down the deaths from misuse. Quality of life is greatly reduced. Thank You.

LarryK

We’ve all been taught that opioids were the best at pain relief for a long time. Older generations practically had it thrown at them in large bags with chronic pain or conditions of unknown causality. So it is ingrained in us right now that those are the best and anything else just doesn’t cut it. I’m betting what is going on here is those prescribed the opioids don’t realize there could be better solutions because of that. So they perceive opioids as “the doc did all he/she could, and is ensuring I have the best pain relief.”

From my own pain experience, opioid prescription tended to be the option for the doctor that didn’t know what else to do and pretty well wanted me out the door. When I finally got to someone who wanted to try every path, the opioids went away. It took years to not only find out the problem, but to also weed through every non opioid medication in order to see if any worked. Many pain patients probably don’t have the patience for that. I know I came very close to my breaking point many times. It seemed as though there was no end in sight and I definitely questioned my choice of doctor a few times. I went through a good 15 other medications to see if any worked. I found a few new medication allergies, but none did without weird side effects.

This is likely the path of a lot of patients who were not prescribed opioids, have been taken off of them to find something better or had a doctor who wanted to get to the root problem and get it fixed (if possible.) In the end, I found two options that worked significantly better than opioids. One I ended up not being able to use as another medical condition made it too high of a risk. The other is CBD oil. Which itself is a grey area.

Until we can find a better solution to opioids that is fully legal, this is likely going to be the outcome for some time. It is ingrained in most everyone that they are the best at pain management. A lot of times they are a band aid at best. One that tends to make things much worse in the long run.

connie

I think if I hear that opioid medication doesn’t work for chronic pain I am going to scream! They can do all the studies they want and because of bias those studies will never show the truth!

HJ

No assessment of severity of degeneration/disease or why doctors opted for opiods for these patients. Just “were they on opiods” or “weren’t they.”

I don’t think doctors roll the dice to determine whether they will prescribe opiods or not.

I’m so uncomfortable with “one size fits all” healthcare models, the loss of doctor autonomy and black & white “Opiods are bad” judgments.

Rachel

It could be that those with worse musculoskeletal pain conditions are given opioids so that is a reflection of the severity of their illness. Interesting I agree I shall follow this research. My consultant (Head of Pain at a top university) also says it’s a complex picture but opioids will also always be part of my pain management. You can always jump in freezing water- that kills Iain for a day 😉