Chronic opioid therapy and preventive services in rural primary care: an Oregon rural practice-based research network study

David I. Buckley, MD, MPH

Oregon Rural Practice-based Research Network
Department of Family Medicine
Department of Medical Informatics and Clinical Epidemiology
Oregon Health & Science University
Portland, Oregon

Chronic noncancer pain is a leading cause of disability, resulting in deleterious effects on multiple patient domains (eg, physical, psychological, cognitive, employment, among others). Opioid prescribing for patients with chronic noncancer pain has increased over the last 2 decades, in part owing to a growing consensus that these medications are an important option for carefully selected patients. Controversy remains for many clinicians, however, who are rightly concerned about adverse events, abuse potential, and the lack of evidence for long-term benefit. These uncertainties may place additional stresses on the clinician–patient relationship. For instance, responsible opioid prescribing is time-consuming, a daunting hurdle for the primary care provider that may detract from other aspects of routine clinical care. Here, Dr. Buckley discusses whether patients on chronic opioid therapy are at risk for inadequate comprehensive healthcare because of reductions in routine preventive services, such as smoking cessation counseling or screening for colorectal cancer, cervical cancer, and dyslipidemia.

References

1.    Buckley DI, Calvert JF, Lapidus JA, Morris CD. Chronic opioid therapy and preventive services in rural primary care: an Oregon rural practice-based research network study. Ann Fam Med. 2010;8(3):237-44.
2.    Chou R, Ballantyne JC, Fanciullo GJ, Fine PG, Miaskowski C. Research gaps on use of opioids for chronic noncancer pain: findings from a review of the evidence for an American Pain Society and American Academy of Pain Medicine clinical practice guideline. J Pain. 2009;10(2):147-159.
3.    Chou R, Fanciullo GJ, Fine PG, et al. Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain. J Pain. 2009;10(2):113-130.

Chronic opioid therapy and preventive services in rural primary care: an Oregon rural practice-based research network study.

Buckley DI, Calvert JF, Lapidus JA, et al.
Ann Fam Med. 2010;8(3):237-44.
PURPOSE:...

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