PTOTSLPOtherJournal of occupational rehabilitation2025

Can General Practitioner Opioid Prescribing to Compensated Workers with Low Back Pain Be Detected Using Administrative Payments Data? An Exploratory Study.

Jennifer Vo, Shannon Gray, Adrian C Traeger and 1 others

PMID 38564158

WHAT IT FOUND

Administrative payment data can detect that at least 35.6% of opioid dispenses to workers with low back pain were likely prescribed by a general practitioner on the same day.

This allows insurers to monitor prescribing trends without needing clinical notes.

Key findings

01Nearly 70% of opioid dispenses had a GP encounter immediately prior in the data sequence, and half of those occurred on the same day.

02Based on this sequence, at least 35.6% of all opioids dispensed to these workers were likely prescribed by a GP.

03The method relies on linking dates and service types in payment records, not on verifying actual prescriptions or dosages.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs

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What it does not show

The study only includes opioids funded by workers' compensation schemes, missing prescriptions paid for out-of-pocket or by private insurance. It does not account for opioids prescribed by other specialists such as surgeons, pain physicians, or occupational physicians. The method assumes that a GP encounter on the same day as a dispense indicates a prescription, but cannot verify this directly. No information on the type, strength, or dose of opioids was included. The sample is limited to workers with accepted claims for low back pain in two Australian states.

Declared interests

Funding was provided by Monash University. No other conflicts of interest were declared.

The easy way to misread this

Do not interpret the 35.6% figure as a measure of inappropriate prescribing or clinical quality. This number only reflects the proportion of dispenses that could be linked to a GP encounter in administrative data. It does not confirm that the GP prescribed the opioid, nor does it indicate whether the prescription was clinically justified.

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