Preventing unsafe opioid prescribing

A research team at the UW Department of Environmental & Occupational Health Sciences (DEOHS) will receive a $5 million funding award from the Patient-Centered Outcomes Research Institute (PCORI) to study strategies to prevent unsafe opioid prescribing in workers’ compensation programs in two states. Dr. Gary Franklin, DEOHS research professor, leads the team. Franklin’s team will compare the effectiveness of two state opioid prescription review programs already in use in Washington and Ohio. Washington uses a prior authorization model, while Ohio uses a retrospective review of opioid prescriptions. more...

Evaluation of the Nurse Case Management Pilot for Workers with Catastrophic Injuries

This project evaluated a pilot program to deliver contracted nurse case management services to workers with catastrophic injuries covered by the Washington Department of Labor and Industries (L&I).  Nurse case management for workers with catastrophic injuries may improve coordination of health care and rehabilitation services; assist with transitions from the hospital to other facilities or to home; improve communication between workers and their families, health care providers, and L&I; and improve worker education and adherence with treatment plans.  The evaluation included: 1) summaries of analyses comparing medical costs and time loss costs before and after implementation of the nurse case management pilot (pre-post analysis), 2) a summary of interviews with injured workers that includes measures of functional status and satisfaction with care, 3) a review of claim files, and 4) an economic analysis of nurse case management costs.

The final UW report can be downloaded from HERE.

Comparative Effectiveness of Two State Payer Strategies to Prevent Unsafe Opioid Prescribing

Since the late 1990s, the United States has seen an epidemic of mortality, overdose, and addiction related to the use of prescription opioids for chronic pain. This has led to over 200,000 deaths and millions addicted. Workers’ compensation systems have been hit particularly hard by the opioid epidemic because the populations most likely to receive longer-term opioid prescriptions have been those with routine musculoskeletal conditions, which are the most common disabling conditions among injured workers. For example, nearly one-third of injured workers with low back injuries in Washington state receive opioids, and receipt of just three prescriptions, or over seven days of opioids in the first six weeks, after injury is associated with a doubling of the likelihood that a worker will become disabled long term. Preliminary data suggest that reducing acute prescribing for injured workers could reverse this disability trend associated with acute prescribing of opioids. The Centers for Disease Control and Prevention have recently also emphasized the potential importance of avoiding opioids if possible in favor of alternative treatments and limiting the number of days opioids can be prescribed for acute pain to three to seven days in most cases. more...

Predictors of Long-Term Disability among Workers with Musculoskeletal Disorders

Investigators: Gary Franklin, Judy Turner, Deborah Fulton-Kehoe, Tom Wickizer, Kathleen Egan and Rae Wu

The purpose of this study is to develop statistical models that accurately predict chronic work disability from data obtained from administrative databases and worker interviews soon after a work injury. Based on these models, we will develop a brief instrument that could be administered in medical or workers' compensation settings to screen injured workers for chronic disability risk soon after injury. more...

Outcome of Lumbar Fusion in Washington State Workers Compensation

Investigators: Sham Juratli, Gary Franklin, Deb Fulton-Kehoe, Shohail Mirza, Rae Wu, Thomas Wickizer

Over the past few years, the rate of lumbar fusion surgery has increased, possibly due to approval of new technological devices. We conducted a population-based cohort study of Washington State injured workers covered by the Department of Labor and Industries who underwent lumbar fusion (LF) between January 1994 and December 2001. more...