A Kaiser Permanente study of nearly 2,500 patients who used high doses of opioids for at least six months showed that reducing their opioid use did not lower their satisfaction with care -- which could have positive reimbursement implications for hospitals.
Patient satisfaction is one of the criteria the Centers for Medicare and Medicaid Services looks at to determine reimbursement -- the more patients report being happy, the more money hospitals receive -- and this reflects a broader wave of consumerism. With the advent of online ratings sites and social media, patients wield considerable power, and increasingly are voting for their preferred providers with their wallets.
Because of that, physicians are often concerned they'll receive lower satisfaction scores if they reduce opioids for patients who are accustomed to high doses to manage chronic pain. The results showed they needn't be.
Opioid use has been a major health concern in the U.S. It increased by 300 percent from 1997 to 2010, and overdose deaths increased 200 percent from 2000 to 2014. An in-depth analysis of U.S. data released by the Centers for Disease Control and Prevention in March showed that drug overdoses killed 63,632 Americans in 2016. Nearly two-thirds of those deaths involved a prescription or illicit opioid.
The study compared patient satisfaction scores between those whose dose was reduced to the recommended level for at least 30 days, and those without such a reduction.
It found that 86.4 percent of physician/patient encounters resulting in an opioid dose reduction maintained favorable overall satisfaction. Reducing opioid doses for chronic pain was not associated with unfavorable patient satisfaction scores, though interestingly, the odds of a favorable satisfaction rating were higher when opioids were reduced by a patient's regular primary care physician versus a different physician.
The authors said they hope the findings will compel physicians to reduce their patients' opioid levels without fear, a move which would result in better patient health in the long run.