Objective To compare adherence to opioid prescribing guidelines and potential opioid misuse in patients of resident versus attending physicians. used logistic regression analysis to assess whether individuals’ physician status predicts guideline adherence and/or potential opioid misuse. Results Related proportions of resident and attending individuals had a controlled substance agreement (45.1% of resident individuals vs. 42.4% of attending patient p=0.47) or urine drug screening (58.6% of resident individuals vs. 63.6% of attending individuals p=0.16). Resident patients were more likely to have two or more early refills in the past year relative to attending individuals (42.8% vs. 32.5%; p=0.004). In the modified regression analysis resident patients were more likely to receive early refills (OR 1.82 95 CI 1.26-2.62) than attending patients. Conclusions With some variability occupants and going to physicians Nivocasan were only partly compliant with national recommendations. Residents were more likely to manage individuals with a higher probability of opioid misuse. Intro Prescription opioid misuse is definitely a significant general public health problem. In 2009 2009 nearly 15 500 intentional and unintentional deaths were attributed to prescription opioids (1). Main care providers are the principal prescribers of opioid medications (2 3 for chronic non-cancer pain and thus serve as a major source of potentially harmful opioids. In response to the epidemic of prescription opioid misuse the American Pain Society generated Nivocasan best practice recommendations for prescribing and mitigating risk of prescription opioids. The recommendations include risk stratification controlled substance agreements and periodic urine drug screening (4). Residents provide a considerable proportion of the care for vulnerable patient populations (5 6 in safety-net private hospitals; such hospitals serve mainly low-income and/or un-insured individuals many of whom may be at risk for prescription opioid misuse. Although resident physicians have been shown to provide higher quality of care in the outpatient establishing for some chronic diseases as compared to attending physicians (7) it is not obvious whether that practice extends to opioid prescribing for chronic pain. One study shown higher use of contracts by residents however no risk modifications were made for patient characteristics (8). Because practice patterns founded in residency are likely to be Nivocasan the basis for lifelong practice a better understanding of these patterns is needed. Furthermore if going to physician practices are not adherent to recommendations it may indicate a need Nivocasan for education and practice changes for attendings as well as residents. This is especially important for attendings who precept occupants and thus help shape resident practice. We carried out a retrospective mix sectional study at an urban safety-net hospital comparing adherence to recommendations on opioid monitoring and prevalence of opioid misuse among individuals of resident versus attending physicians. Our hypothesis was that resident physicians provide related care to attending physicians given that they are becoming trained and monitored by these same physicians. Methods We carried out a retrospective cross-sectional study at the general internal medicine (GIM) primary care practice of Boston Medical Center (BMC) which cares for approximately 30 0 unique individuals. Data was abstracted from your electronic health record (EHR) through the institution’s medical data warehouse. The Institutional Review Table at Boston University or college authorized this study. Study Sample We identified individuals age 18 to 89 years who met the following criteria: 1) one or more Rabbit Polyclonal to Src. completed visits to the GIM Nivocasan practice from August 31 2011 to September 1 2012 2 received long-term opioid treatment (defined as three or more opioid prescriptions written at least 21 days apart within a six-month period) for chronic non-cancer pain; (2) 3) A GIM main care provider (physician or nurse practitioner) authorized the opioid prescriptions. We excluded individuals who were receiving care for malignancy (except non-melanoma pores and skin malignancy) as defined by ICD-9-CM codes within the EMR problem list and three or more visits in the past year to the.