title: Timeliness of Care Planning upon Initiation of Chronic Opioid Therapy for Chronic Pain.
abstract: Chronic opioid therapy (COT) guidelines recommend developing a COT care plan at the initiation of COT.
  
  
  
  Assess the timeliness of care planning upon initiation of COT.
  
  
  
  Observational cohort study in a setting incentivizing and tracking documentation of COT care plans in electronic health records (EHRs).
  
  
  
  Study participants (N = 896) were aged 45 years or older, had initiated an episode of opioid use within the prior 6 months, and reported regular use of prescription analgesics when screened for a baseline interview about 3 months after an index opioid prescription MEASURES: A timely care plan was defined by an EHR documented care plan prior to or within 4 months after the index opioid prescription.
  
  
  
  Among COT initiators, 30% had a timely COT care plan documented in the EHR within 4 months following index prescription, while 51% had a documented COT care plan within 12 months following index prescription. Among those interviewed at 1 year follow-up (N = 735), 252 (34.2%) reported opioid use on 7 or more days in the prior 2 weeks. Less than half (45.6%) of the 252 individuals who sustained regular opioid use at 1 year had predicted at baseline that it was somewhat, very, or extremely likely they would be using opioids regularly in 1 year.
  
  
  
  Patients initiating COT were unlikely to have timely COT care plans. Many who sustained regular opioid use at 1 year had not anticipated using opioids long term.
authors.affiliation: *Group Health Research Institute, Seattle, Washington, USA; vonkorff.m@ghc.org.
authors.forename: Michael
authors.initials: M
authors.lastname: Von Korff
authors.affiliation: Departments of Psychiatry and Behavioral Sciences.|Rehabilitation Medicine.|Anesthesiology and Pain Medicine.
authors.forename: Judith A
authors.initials: JA
authors.lastname: Turner
authors.affiliation: *Group Health Research Institute, Seattle, Washington, USA.|Biostatistics, and.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Shortreed
authors.affiliation: *Group Health Research Institute, Seattle, Washington, USA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Saunders
authors.affiliation: *Group Health Research Institute, Seattle, Washington, USA.
authors.forename: Dori
authors.initials: D
authors.lastname: Rosenberg
authors.affiliation: Departments of Psychiatry and Behavioral Sciences.|Geriatric Research, Education, and Clinical Center, Puget Sound Veterans Affairs Medical Center, Seattle, Washington, USA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Thielke
authors.affiliation: Oral Medicine, University of Washington, Seattle, Washington, USA.
authors.forename: Linda
authors.initials: L
authors.lastname: LeResche
mesh_terms: D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D059350:Chronic Pain / Q000188:drug therapy* / Q000453:epidemiology*; D015331:Cohort Studies; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007407:Interviews as Topic / Q000379:methods; D008297:Male; D008875:Middle Aged; D010347:Patient Care Planning; D013997:Time Factors; D014861:Washington / Q000453:epidemiology
chemical_list: D000701:Analgesics, Opioid
keywords: Chronic Pain; Opioids; Primary Care; Quality of Health Care
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