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Clinical need absent, unclear in nearly 30 percent of US outpatient opioid prescriptions

Nearly 30 percent of outpatient opioid prescriptions in the United States lack documented clinical reasons that justify the use of these potent drugs, according to a national analysis of physician visit records. The results raise concerns about inappropriate prescribing, lax documentation practices or a combination thereof. Research has shown that the medical use of opioids has risen dramatically over the past 20 years, outpacing the actual prevalence of pain -- a trend that may be partly fueled by inappropriate prescription practices for conditions that do not warrant treatment with opioids, according to the researchers who worked on the analysis. Absence of clear documentation could also be a symptom of deeper systemic issues that prevent physicians' note-keeping, such as time pressures or complicated documentation interfaces. For the study, the researchers analyzed data from the National Ambulatory Medical Care Survey on opioid prescriptions dispensed during doctor's office visits between 2006 and 2015. The researchers say their results underscore the need for stricter requirements on documenting the need for opioids -- an approach many insurance providers already use to determine approval of new, costly drugs. Additionally, the researchers believe that the findings should prompt policymakers to seek ways to simplify clinical documentation systems.

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