Factors associated with early opioid dispensing compared with NSAID and muscle relaxant dispensing after a work-related low back injury

2020 ◽  
Vol 77 (9) ◽  
pp. 637-647
Author(s):  
Nancy Carnide ◽  
Sheilah Hogg-Johnson ◽  
Pierre Côté ◽  
Mieke Koehoorn ◽  
Andrea D Furlan
Keyword(s):  
Drug Class ◽  
Multinomial Logistic Regression ◽  
Workers Compensation ◽  
Low Back ◽  
Historical Cohort ◽  
Physician Visits ◽  
Factors Associated ◽  
Healthcare Data ◽  
Work Related ◽  
International Statistical Classification

ObjectivesThe objective of this historical cohort study was to determine the claimant and prescriber factors associated with receiving opioids at first postinjury dispense compared with non-steroidal anti-inflammatory drugs (NSAIDs) and skeletal muscle relaxants (SMRs) in a sample of workers’ compensation claimants with low back pain (LBP) claims between 1998 and 2009 in British Columbia, Canada.MethodsAdministrative workers’ compensation, prescription and healthcare data were linked. The association between claimant factors (sociodemographics, occupation, diagnosis, comorbidities, pre-injury prescriptions and healthcare) and prescriber factors (sex, birth year, specialty) with drug class(es) at first dispense (opioids vs NSAIDs/SMRs) was examined with multilevel multinomial logistic regression.ResultsIncreasing days supplied with opioids in the previous year was associated with increased odds of receiving opioids only (1–14 days OR 1.62, 95% CI 1.51 to 1.75; ≥15 days OR 5.12, 95% CI 4.65 to 5.64) and opioids with NSAIDs/SMRs (1–14 days OR 1.49, 95% CI 1.39 to 1.60; ≥15 days OR 2.82, 95% CI 2.56 to 3.12). Other significant claimant factors included: pre-injury dispenses for NSAIDs, SMRs, antidepressants, anticonvulsants and sedative-hypnotics/anxiolytics; International Statistical Classification of Diseases and Related Health Problems, 9th Revision diagnosis; various pre-existing comorbidities; prior physician visits and hospitalisations; and year of injury, age, sex, health authority and occupation. Prescribers accounted for 25%–36% of the variability in the drug class(es) received, but prescriber sex, specialty and birth year did not explain observed between-prescriber variation.ConclusionsDuring this period in the opioid crisis, early postinjury dispensing was multifactorial, with several claimant factors associated with receiving opioids at first prescription. Prescriber variation in drug class choice appears particularly important, but was not explained by basic prescriber characteristics.

scholarly journals Relationship between early prescription dispensing patterns and work disability in a cohort of low back pain workers’ compensation claimants: a historical cohort study

2019 ◽  
Vol 76 (8) ◽  
pp. 573-581 ◽  
Author(s):  
Nancy Carnide ◽  
Sheilah Hogg-Johnson ◽  
Mieke Koehoorn ◽  
Andrea D Furlan ◽  
Pierre Côté
Keyword(s):  
Cohort Study ◽  
Low Back Pain ◽  
Back Pain ◽  
Work Disability ◽  
Workers Compensation ◽  
Low Back ◽  
Historical Cohort ◽  
Healthcare Data ◽  
Historical Cohort Study ◽  
Strong Opioids

ObjectivesTo examine and compare whether dispensing of prescription opioids, non-steroidal anti-inflammatory drugs (NSAIDs) and skeletal muscle relaxants (SMRs) within 8 weeks after a work-related low back pain (LBP) injury is associated with work disability.MethodsA historical cohort study of 55 571 workers’ compensation claimants with LBP claims in British Columbia from 1998 to 2009 was conducted using linked compensation, dispensing and healthcare data. Four exposures were constructed to estimate the effect on receipt of benefits and days on benefits 1 year after injury: drug class(es) dispensed, days' supply, strength of opioids dispensed and average daily morphine-equivalent dose.ResultsCompared with claimants receiving NSAIDs and/or SMRs, the incidence rate ratio (IRR) of days on benefits was 1.09 (95% CI 1.04 to 1.14) for claimants dispensed opioids only and 1.26 (95% CI 1.22 to 1.30) for claimants dispensed opioids with NSAIDs and/or SMRs. Compared with weak opioids only, the IRR for claimants dispensed strong opioids only or strong and weak opioids combined was 1.21 (95% CI 1.12 to 1.30) and 1.29 (95% CI 1.20 to 1.39), respectively. The incident rate of days on benefits associated with each 7-day increase in days supplied of opioids, NSAIDs and SMRs was 10%, 4% and 3%, respectively. Similar results were seen for receipt of benefits, though effect sizes were larger.ConclusionsFindings suggest provision of early opioids leads to prolonged work disability compared with NSAIDs and SMRs, though longer supplies of all drug classes are also associated with work disability. Residual confounding likely partially explains the findings. Research is needed that accounts for prescriber, system and workplace factors.

Gender differences in work-related risk factors associated with low back symptoms

Ergonomics ◽  
2012 ◽  
Vol 55 (3) ◽  
pp. 327-342 ◽  
Author(s):  
Baiduri Widanarko ◽  
Stephen Legg ◽  
Mark Stevenson ◽  
Jason Devereux ◽  
Amanda Eng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gender Differences ◽  
Low Back ◽  
Factors Associated ◽  
Work Related ◽  
Related Risk

scholarly journals Risk factors associated with work-related musculoskeletal disorders in dentistry

2016 ◽  
Vol 39 (6) ◽  
pp. 192 ◽  
Author(s):  
Sinem Bozkurt ◽  
Nesrin Demirsoy ◽  
Zafer Günendi
Keyword(s):  
Hospital Admissions ◽  
Working Hours ◽  
Musculoskeletal Symptoms ◽  
Risk Exposure ◽  
Low Back ◽  
Factors Associated ◽  
Work Related ◽  
Work Related Musculoskeletal Disorders ◽  
Exposure Levels ◽  
Research Assistants

Purpose: To evaluate musculoskeletal system-related complaints; identify regions at risk in dentists by observing and inquiring the dentists at work; and find out the associations with age, sex, working years, academic position and departments, positions during work and daily working hours. Methods: Modified Nordic Questionnaire (m-nMQ) was used to evaluate pain, hospital admissions and absenteeism. Quick Exposure Check (QEC) form was utilized to assess risk exposure levels related with low-back, neck, hand-wrist and shoulder-arm. Results: 163 dentists were included the most painful regions were found to be back (66.9%), neck (65%) and low back (64.4%). Musculoskeletal symptoms were more prevalent in women and research assistants. QEC scores were found to be lower in those who performed regular exercises. Conclusion: Dentists should be educated about ergonomics at the beginning of their professional life.

scholarly journals Work-Related Injuries Reported to Workers Compensation Fund in Tanzania from 2016 to 2019

2021 ◽  
Vol 18 (17) ◽  
pp. 9152
Author(s):  
Brenda Shewiyo ◽  
Hussein Mwanga ◽  
Ezra Mrema ◽  
Simon Mamuya
Keyword(s):  
Traffic Accidents ◽  
Office Workers ◽  
Quality Data ◽  
Workers Compensation ◽  
Security Guards ◽  
Factors Associated ◽  
Work Related ◽  
And Storage ◽  
Archival Study ◽  
Fatal Injuries

Quality data on the magnitude and determinants of work-related injuries is an important element in the development of appropriate preventative strategies. However, there have been many challenges in obtaining quality information on work-related injuries in the developing countries. This archival study based on the data from workers’ compensation registry from the year 2016 to 2019 aimed at determining trends and factors associated with work-related injuries (WRI). Data from 4578 WRI claims reported to Workers Compensation Fund (WCF) in Tanzania were analyzed. As expected, this new workers’ compensation system had increasing participation from inception in 2016 through 2019, resulting in increasing numbers of fatal and non-fatal work-related claims. Motor traffic accidents, machine faults and falls were the most reported causes of WRI. Males had more than 2-fold increased odds of sustaining fatal injuries compared to females. More than 6-fold increased odds of fatal injuries were observed for injuries occurring during conveyance. Explosions, motor traffic accidents, and falls were more likely to result into fatal injuries. Increased odds of fatal injuries were observed in workers from transportation and storage sector; information and technology; construction and building; and electricity, gas, and steam sectors, as well as among teachers, drivers, office workers, and security guards. The current study offers some insights regarding trends and associated factors that are vital in planning and implementation of appropriate preventative strategies for work-related injuries in Tanzania.

scholarly journals Satisfying medical and rehabilitation needs positively influences returning to work after a work-related injury: an analysis of national panel data from 2018 to 2019

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Suk Won Bae ◽  
Min-Yong Lee ◽  
Shin Who Park ◽  
Gangpyo Lee ◽  
Ja-Ho Leigh
Keyword(s):  
Return To Work ◽  
Initial Treatment ◽  
Original Work ◽  
Multinomial Logistic Regression ◽  
Panel Study ◽  
Medical Rehabilitation ◽  
Workers Compensation ◽  
Work Related ◽  
Medical Needs ◽  
Rehabilitation Needs

Abstract Background This study examined how meeting the medical needs of injured workers after initial treatment may affect their return to work, using data from the Panel Study of Workers’ Compensation Insurance. Methods This study was designed as a longitudinal study, which used data from the second-year, follow-up survey conducted in the secondary cohort of the Panel Study of Workers’ Compensation Insurance. The odds ratio (OR) and 95% confidence interval were estimated through binomial and multinomial logistic regression analyses to examine the effects of unmet medical needs on workers’ return to original work and return to work overall (including reemployment). Results The returned to original work OR of workers whose rehabilitation needs were met was 1.35 (1.12–1.63) while the return to work OR was 1.20 (1.03–1.41). The returned to original work OR of workers whose medical needs were met was 1.64 (1.18–2.27) while the return to work OR was 1.39 (1.07–1.80). In terms of disability rating, the return to work ORs of workers with mild disabilities whose medical/rehabilitation needs were not met and those of workers without disabilities were 1.71 (1.17–2.49) and 1.97 (1.27–3.08), respectively. In the case of regular/temporary workers, the returned-to-work ORs of workers whose medical/rehabilitation needs were not met were 1.54 (1.12–2.13) and 1.27 (1.03–1.56), respectively. Conclusions For workers who sustained work-related injuries, providing medical accessibility and meeting rehabilitation needs were found to be important predictors of return to work after initial treatment.

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