Documented Pain Diagnoses in Adults Prescribed Opioids
Authors: Tisamarie B. Sherry, Adrienne Sabety, Nicole Maestas
Journal: Annals of Internal Medicine (2019)

Letters20 August 2019Documented Pain Diagnoses in Adults Prescribed OpioidsTisamarie B. Sherry, MD, PhD, Adrienne Sabety, BA, and Nicole Maestas, MPP, PhDTisamarie B. Sherry, MD, PhDThe RAND Corporation, Arlington, Virginia (T.B.S.)Search for more papers by this author, Adrienne Sabety, BAHarvard University, Cambridge, Massachusetts (A.S.)Search for more papers by this author, and Nicole Maestas, MPP, PhDHarvard Medical School, Boston, Massachusetts (N.M.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L19-0215 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Weiser questions whether using provider-assigned diagnoses recorded in the NAMCS as ICD-9 codes led to an overestimation of the percentage of opioid prescriptions lacking a documented medical indication. He notes that these codes may only reflect billed services, whereas including diagnoses noted in the narrative section of progress notes would capture additional justifications for opioid prescribing. To respond, clarifying how clinical encounter data are recorded in the NAMCS is important. For each visit, the NAMCS reports up to 3 or 5 (depending on the survey year) provider-assigned diagnoses that are abstracted from a review of medical charts ...References1. Bouland DT, Fine E, Withers D, et al. Prescription medication obtainment methods and misuse. J Addict Med. 2015;9:281-5. [PMID: 25961496] doi:10.1097/ADM.0000000000000130 CrossrefMedlineGoogle Scholar2. Grover CA, Close RJ, Wiele ED, et al. Quantifying drug-seeking behavior: a case control study. J Emerg Med. 2012;42:15-21. [PMID: 21958455] doi:10.1016/j.jemermed.2011.05.065 CrossrefMedlineGoogle Scholar3. Samet JH, Botticelli M, Bharel M. Methadone in primary care—one small step for Congress, one giant leap for addiction treatment. N Engl J Med. 2018;379:7-8. [PMID: 29972744] doi:10.1056/NEJMp1803982 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: The RAND Corporation, Arlington, Virginia (T.B.S.)Harvard University, Cambridge, Massachusetts (A.S.)Harvard Medical School, Boston, Massachusetts (N.M.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-0644. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoDocumented Pain Diagnoses in Adults Prescribed Opioids: Results From the National Ambulatory Medical Care Survey, 2006–2015 Tisamarie B. Sherry , Adrienne Sabety , and Nicole Maestas Documented Pain Diagnoses in Adults Prescribed Opioids Daniel B. Horton , Theresa Juliano , Matthew T. Taylor , and Tobias Gerhard Documented Pain Diagnoses in Adults Prescribed Opioids John Weiser Metrics 20 August 2019Volume 171, Issue 4Page: 307-308KeywordsDisclosureElectronic medical recordsInternational classification of diseases ninth revisionOpioid addictionOpioid use disorderOpioidsPatientsPrevention, policy, and public healthResearch reporting guidelinesSubstance abuse ePublished: 20 August 2019 Issue Published: 20 August 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...