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Demographic characteristics and clinical predictors of patients discharged from university hospital-affiliated pain clinic due to breach in narcotic use contract

Shushovan Chakrabortty, MD, PhD, Deepak Gupta, MD, David Rustom, MD, Hussein Berry, Ajit Rai

Abstract


Objective: The current retrospective study was completed with the aim to identify

demographic characteristics and clinical predictors (if any) of the patients discharged

from our pain clinic due to breach in narcotic use contract (BNUC).

Design: Retrospective patient charts' review and data audit.

Setting: University hospital-affiliated pain clinic in the United States.

Participants: All patient charts in our pain clinic for a 2-year period (2011-2012).

Interventions: The patients with BNUC were delineated from the patients who had not been discharged from our pain clinic.

Main outcome measures: Pain characteristics, pain management, and substance abuse status were compared in each patient with BNUC between the time of admission and the time of discharge.

Results: The patients with BNUC discharges showed significant variability for the discharging factors among the pain physicians within a single pain clinic model with this variability being dependent on their years of experience and their proactive interventional pain management. The patients with BNUC in our pain clinic setting were primarily middle-aged, obese, unmarried males with nondocumented stable occupational history who were receiving only noninterventional pain management. Substance abuse, doctor shopping, and potential diversion were the top three documented reasons for BNUC discharges.

Conclusion: In 2011-2012, our pain clinic discharged 1-in-16 patients due to breach in narcotic use contract.


Keywords


narcotic use contract, discharges from pain clinics, doctor shopping, substance abuse, medication diversion

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References


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DOI: https://doi.org/10.5055/jom.2014.0237

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