Elizabeth T. Masters

The Comparative Burden of Chronic Widespread Pain and Fibromyalgia in the United States.

Little information exists on the comparative patient and economic burden of chronic widespread pain (CWP) and fibromyalgia (FM) in the United States.

Economic Burden of Prescription Opioid Misuse and Abuse: A Systematic Review

ABSTRACT A 2009 systematic review found that the total cost of prescription opioid abuse in 2001 in the United States was approximately

The prevalence of problem opioid use in patients receiving chronic opioid therapy: computer-assisted review of electronic health record clinical notes

8.6 billion and medical expenses were estimated to be

Evaluating Guideline-recommended Pain Medication Use Among Patients with Newly Diagnosed Fibromyalgia.

15,884 for opioid abusers and

Electronic medical record data to identify variables associated with a fibromyalgia diagnosis: importance of health care resource utilization.

1,830 for nonabusers. A search was conducted for English publications on the cost of prescription opioid abuse and misuse from 2009 to 2014. The initial literature search identified 5,412 citations. Title and abstract review selected 59 for further review. The final review process resulted in 16 publications for inclusion that examined cost from the payer perspective. Mean costs to the payer for abusers were

Medical outcomes associated with prescription opioid abuse via oral and non-oral routes of administration

23,000–

THU0321 Multisite Prospective Observational Study of Fibromyalgia Patients in the Us

25,000 per year and excess costs approximately

Interpreting Effect Sizes and Clinical Relevance of Pharmacological Interventions for Fibromyalgia

15,000 per patient. Three papers were identified that presented societal costs, including direct and indirect costs such as criminal justice costs and costs associated with lost productivity. The strongest evidence suggests that societal cost is in excess of

Progression of fibromyalgia: results from a 2-year observational fibromyalgia and chronic pain study in the US.

50 billion per year in the United States. Prescription opioid abuse and misuse is a common and important problem throughout the world that has significant associated societal costs and excess medical costs.

Identification of a potential fibromyalgia diagnosis using random forest modeling applied to electronic medical records

Abstract To estimate the prevalence of problem opioid use, we used natural language processing (NLP) techniques to identify clinical notes containing text indicating problem opioid use from over 8 million electronic health records (EHRs) of 22,142 adult patients receiving chronic opioid therapy (COT) within Group Health clinics from 2006 to 2012. Computer-assisted manual review of NLP-identified clinical notes was then used to identify patients with problem opioid use (overuse, misuse, or abuse) according to the study criteria. These methods identified 9.4% of patients receiving COT as having problem opioid use documented during the study period. An additional 4.1% of COT patients had an International Classification of Disease, version 9 (ICD-9) diagnosis without NLP-identified problem opioid use. Agreement between the NLP methods and ICD-9 coding was moderate (kappa = 0.61). Over one-third of the NLP-positive patients did not have an ICD-9 diagnostic code for opioid abuse or dependence. We used structured EHR data to identify 14 risk indicators for problem opioid use. Forty-seven percent of the COT patients had 3 or more risk indicators. The prevalence of problem opioid use was 9.6% among patients with 3 to 4 risk indicators, 26.6% among those with 5 to 6 risk indicators, and 55.04% among those with 7 or more risk indicators. Higher rates of problem opioid use were observed among young COT patients, patients who sustained opioid use for more than 4 quarters, and patients who received higher opioid doses. Methods used in this study provide a promising approach to efficiently identify clinically recognized problem opioid use documented in EHRs of large patient populations. Computer-assisted manual review of EHR clinical notes found a rate of problem opioid use of 9.4% among 22,142 COT patients over 7 years.