Doctors Who Stay Current on Medical Knowledge Less Likely to Overprescribe Opioids

Physicians who stay current on medical knowledge are less likely to overprescribe opioids for back pain, according to a study published last week by researchers from Harvard University and the American Board of Internal Medicine.

The study, published July 1 by JAMA Open, looked at knowledge scores 10,246 mid-career general internists on the ABIM Maintenance of Certification Exam, as well as opioid prescribing practices between 2009 and 2017. During that period overall, opioids were prescribed for 21.6% of 55,387 office visits for new onset lower back pain. With new information about the scope of the opioid epidemic began to emerge from 2015 to 2017, prescribing guidelines were revised.

During that 3-year period, the physicians who scored highest on the ABIM MOC exam were found to be 20% less likely to prescribe opioids for new onset lower back pain. From 2009-14, there were no discernible differences in opioid prescribing for lower back pain between high-scoring and low-scoring physicians on the ABIM MOC.

“Our study reinforces that physicians with greater clinical knowledge were more likely to change their behavior to match evolving clinical guidelines around opioid prescribing,” study senior author Michael Barnett, MD, of the Harvard T.H. Chan School of Public health, said in a statement. “Yet, even physicians who scored in the top quartile of ABIM’s exam prescribed opioids at disappointingly high rates given that they are not first-line therapy for back pain. This finding suggests that more targeted interventions are also required.”