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Under-Treatment of Pain Exacerbated by Public Perceptions of Medicines and Safety
Date:1/29/2009

e were taking street drugs like marijuana with the medicines, which is contraindicated," said David Miller, MD, director at the Woodland Pain Center in Michigan City, Indiana, and lead author of the study. "There's also a possibility it was being diverted. When patients were made aware that we could monitor all the prescriptions they were being given by doctors statewide, we saw a reduction in all of this behavior. The electronic monitoring was effective."

Dr. Miller and his colleagues at Woodland Pain Center in Indiana compared two groups of 125 consecutive patients in their interventional chronic pain practice to look at opiate compliance. Group one was evaluated before Inspect was available, group two after its availability. Both were given UDS to test for illicit and prescription drugs.

Researchers saw increased compliance with the pain medicine regime (meaning they were taking the medicine and had less evidence of street drug in their screen) when the patients were aware that their doctor had access to Incident that would allow him or her to see all the prescriptions they were prescribed (Group two). Researchers saw a nearly two-thirds decrease in abnormal UDS.

In the patient population evaluated in this study, after six months of awareness they were included in the electronic database, there was a decrease in opiate abuse (unsanctioned prescriptions) and their use of street drugs in combination with their pain medicines decreased.

"This is dangerous for the obvious reasons, but it also draws more attention to the abuse of needed pain medicines rather than the success with prescribed pain medicines. As a result, patients who would be compliant, but are fearful or would rather not bother trying to get medicine based on what they hear, are not getting the treatment they deserve," Dr. Miller concluded.

In this study, socioeconomic factors such as age, type of insuran
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SOURCE American Academy of Pain Medicine
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