Pasadena, CA—Concerns about alienating patients keep many providers from prescribing from lower opioid dosages, but a new study suggests that fear is misplaced.

The study, published in The American Journal of Managed Care, found that patients’ satisfaction with care didn’t drop with their opioid levels. To come to that conclusion, Kaiser Permanente researchers conducted a study of nearly 2,500 patients who used high doses of opioids for at least 6 months.

“Physicians are often concerned they will receive lower satisfaction scores if they reduce opioids for patients who are accustomed to high opioid doses to manage chronic pain,” explained lead author, Adam L. Sharp, MD, MS, of Kaiser Permanente Southern California Department of Research & Evaluation. “This study showed that following current recommendations and reducing opioids for chronic pain did not result in lower satisfaction scores.”

For the study, researchers tracked patient encounters from 2009 to 2014 among Kaiser Permanente members in Southern California. Included were 2,492 encounters with chronic-pain patients prescribed high doses of opioids for at least 6 consecutive months.

Patient satisfaction scores were compared between two groups—those whose dose was reduced to the recommended level for at least 30 days following the encounter with which the satisfaction score was linked—and other patients who had no reductions.

In addition to determining that favorable overall satisfaction was maintained in most encounters, 86.4%, resulting in an opioid dose reduction, the study also found that patients’ satisfaction scores held steadier when the regular primary care physician, not a different provider, reduced the dosage.

“If you are physician, you should do the right thing and you should feel comfortable you will not receive lower patient satisfaction scores. Our results should reassure physicians and help promote use of recommended guidelines,” Sharp added. “Even if you are in the small subset of physicians reducing opioids for people who are not your regular patients, there is still only small difference in overall patient satisfaction.”

He advised that prescribers tell patients, “Even if you have been on opioids for years, the recommendations have changed.”

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