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Smaller health-care practices are more likely to adopt opioid policies than large ones, study finds

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The widespread misuse of opioids has led to strict regulation of their legitimate, safe application as a medically supervised pain treatment. Still, strategies for prescribing opioids vary significantly across different health care settings. Health care facilities that lack the resources to ensure proper prescribing and administration of these highly addictive substances, for example, issue fewer prescriptions. 

Now, a new study from the Texas A&M University School of Public Health answers an important question regarding such disparities: which has a greater association with strategies for safely prescribing opioids—the practice itself or the practitioner who works there?

“The decision to prescribe opioids is influenced by factors such as a clinic’s location and size, and the health care practitioner’s beliefs about the opioid crisis in the local area,” said the study’s lead author, Dr. Marcia Ory, Regents and Distinguished Professor of environmental and occupational health, and co-chair of the Texas A&M Opioid Task Force. “We hypothesized that small facility size and rural location would hinder the implementation of opioid-prescribing policy or strategies, and that the provider’s perceived local needs for such policies and strategies would help.”

The statistical analysis, however, found that only one variable—practice size—was significantly associated with having a policy restricting opioid prescribing.

The results of this study were contrary to expectations, Ory said. Physicians from practices with fewer than 30 physicians had 3.46 times greater odds of having a policy restricting opioid prescribing than those from larger practices.

Others involved in the study, published in Evaluation & The Health Professions, were Dr. Matthew Lee Smith, associate professor in Texas A&M’s Department of Health Behavior, Dr. Joy Alonzo, associate professor of clinical pharmacy at the Texas A&M School of Pharmacy, Dr. Shinduk Lee, professor in the University of Utah’s College of Nursing, and Dr. Nicole Pardo, CEO of InTech Health.