Long-term opioid therapy, aberrant behaviors, and substance misuse: comparison of patients treated by resident and attending physicians in a general medical clinic.

摘要: Objective: To compare rates of opioid prescribing, aberrant behaviors, and indicators substance misuse in patients prescribed long-term opioids by resident physicians or attending a general internal medicine practice. Design: Medical records 333 who were for at least three consecutive months reviewed. Aberrant behaviors over 2-year period documented, including reporting lost stolen medications receiving from more than one provider. Indicators also recorded, positive urine drug testing illicit substances, addiction treatment, overdose, altering prescriptions. Results: An estimated 13.6 percent the followed residents had been months; this was significantly higher rate attendings (5.9 percent, p < 0.001). Patients likely to have reported prescriptions medication (25.7 vs 12.2 = 0.03) received another provider (17.8 7.6 0.008); they exhibit an indicator (24.8 However, multivariate analyses, not associated with having physician. Conclusions: Resident our institution are following disproportionate number on opioids, many whom misuse. This underscores need better training supervision provide effective safe care chronic pain.