Skip to main content
AAPM&R 2025 Main banner
JFK
Final Program


Official Program
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Presentation Icons
On Demand
On Demand
In-Person
In-Person
Livestream
Livestream
Invite Only
Invite Only
Ticketed
Ticketed
Coffee Break
Coffee Break
Meal
Meal
Reception
Reception
Rate ePoster

Pain and Spine Medicine

Session: Assessing Differences in Opioid Prescription & Safety Practices In Patients Seeking Care at a Veterans Affairs (VA) Chronic Pain Clinic or in the Community

Assessing Differences in Opioid Prescription and Safety Practices In Patients Seeking Care at a Veterans Affairs (VA) Chronic Pain Clinic or in the Community

Thursday, October 23, 2025
5:00 PM - 6:30 PM MT
Location: Open Kiosks
Has Audio

    Poster Presenter(s)

  • Sneh Patel, MD

    Resident Physician
    UCLA David Geffen SOM/ UCLA Medical Center/VA Greater Los Angeles Health
    Los Angeles, California

    • Co-Author(s)

  • QC

    Quinn Convery, Pharm.D

    Clinical Pharmacy Specialist - Pain
    VA
    Los Angeles, California

  • JB

    Jessie Bjella, MD

    Physical Medicine & Rehab Physician
    UCLA David Geffen SOM/ UCLA Medical Center/VA Greater Los Angeles Health
    Los Angeles, California

  • MM

    Majid Mekany, MD

    Physician
    UCLA David Geffen SOM/ UCLA Medical Center/VA Greater Los Angeles Health
    Los Angeles, California

  • AB

    Ariel Baria, NP

    Nurse Practitioner
    UCLA David Geffen SOM/ UCLA Medical Center/VA Greater Los Angeles Health
    Los Angeles, California

  • Sanjog Pangarkar, MD

    Professor, Department of Medicine, UCLA
    VA Med Center/UCLA Med Center
    Los Angeles, California

Disclosure(s):
Sneh Patel, MD: No financial relationships to disclose
Sanjog Pangarkar, MD: No financial relationships to disclose
Background and/or Objectives: To examine opioid practices and risk mitigation in veterans receiving care at the Greater Los Angeles Veterans Affairs (VA) Pain Clinic or from outside providers through Care in the Community (CITC)

Design: Retrospective chart review & analysis of patient data.

Setting : Outpatient Pain clinic(s).

Participants : Patients who received long term (>=90 days) of an opioid prescription between July 1, 2018 - June 30, 2019. Participants were excluded if they had active scripts for methadone or buprenorphine products for substance use disorder.

Interventions: Observational - no intervention was implemented.

Main Outcome Measures: To identify differences in prescription data (e.g. type, morphine equivalent daily dose (MEDD), refill duration) and safety checks (urine toxicology, long-term opioid consent, state prescription drug monitoring (PDMP), naloxone rescue kit) across groups.

Results: The population consisted of 46 CITC and 50 VA patients. Baseline demographics and pain diagnoses were statistically similar, suggesting comparable patient samples. Providers in either group recommended non-pharmacological and non-opioid analgesics at similar rates. The most commonly prescribed opioids were hydrocodone and oxycodone products, and the groups were prescribed these at similar durations and within comparable MEDDs. The VA more frequently checked long-term opioid consents (96% VA vs. 65% CITC, p< 0.005) and urine drug screens (92% VA vs 69.6% CITC, p=0.006), while CITC more frequently followed-up at 3-month intervals (60.9% CITC vs. 26% VA, p< 0.005). Both groups had comparable frequencies for naloxone (30.4% CITC vs. 30% VA, p=0.96) and PDMP (98% vs. 93.5%, p=0.25).

Conclusions: Opioid prescription behaviors were similar between VA and CITC providers, as were most opiate safety measures. VA providers tended to be slightly more conservative in their opioid prescriptions compared to CITC providers, but the latter had more frequent follow-up of their patients. Continued research is needed to understand areas of collaboration and mechanisms to improve pain care delivery for veterans receiving care at VA and in CITC.