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I Must Be Missing Something…

Dr. Adam Richardson
Director of Physician Services
Claims Eval Inc.

A Medscape article from 6/3/16 shared the details of a JAMA – Internal medicine article by Shaheed et al. (http://archinte.jamanetwork.com/article.aspx?articleid=2522397) – meta-analysis level research which demonstrated that opioid analgesics provide modest short-term pain relief, but the effect is not likely to be clinically important. The article also demonstrated that evidence of long-term efficacy is lacking.

Then on 6/6/16, Medscape shared the results of Bao et al.’s article (http://content.healthaffairs.org/content/35/6/1045.abstract) which explained that the effects on overall opioid prescribing and prescribing of non-opioid analgesics were limited. The article found that prescription drug monitoring programs (PDMP’s) did not reduce the overall opioid prescription rate. Instead, they only reduced the percentage of Schedule II drugs. And that reduction was by 1.8%.

Perhaps my years in administrative medicine have caused me to become jaded, but I struggle to understand why providers continue to prescribe long-term medications which have not been demonstrated to have benefit. Has the business of medicine (and the business fear of loss of revenue) become so pervasive that it has overshadowed the art of medicine with its commitment to the Hippocratic oath?