The impact of referral wait times on high‐risk medication usage in patients with chronic pain: a tertiary pain clinic retrospective chart audit.

Background: Increasing demand for specialist pain clinics for patients with chronic non‐cancer pain has led to longer wait times. The shift towards multimodal analgesia has raised significant safety concerns, particularly in vulnerable populations, yet remains unexplored. Aim: This study aimed to in...

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Published in:Journal of Pharmacy Practice & Research Vol. 55; no. 6; pp. 500 - 510
Main Authors: Tynan, Kristin E., Borg, Samantha J., Aitcheson, Nicholas, Cheung, Christy, Ownsworth, Tamara
Format: research tables/charts Journal Article
Published: Wiley-Blackwell Dec2025
Online Access:View this record in EBSCOhost
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      dt: Dec2025
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1002/jppr.70034
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        atl: The impact of referral wait times on high‐risk medication usage in patients with chronic pain: a tertiary pain clinic retrospective chart audit.
      aug:
        au:
          Tynan, Kristin E.
          Borg, Samantha J.
          Aitcheson, Nicholas
          Cheung, Christy
          Ownsworth, Tamara
        affil: Metro South Persistent Pain Clinic, Princess Alexandra Hospital, Brisbane, Australia
      sug:
        subj:
          Referral and Consultation
          Waiting Lists
          Drug Utilization Evaluation
          Chronic Pain Drug Therapy
          Analgesics, Opioid Therapeutic Use
          Pain Management
          Pain Clinics
          Tertiary Health Care
          Gabapentin Therapeutic Use
          Antianxiety Agents, Benzodiazepine Therapeutic Use
          Time Evaluation
          Analgesics, Opioid Administration and Dosage
          Drug Utilization Trends
          Human
          Retrospective Design
          Record Review
          Male
          Female
          Adult
          Middle Age
          Audit
          Hospitals, Public
          Queensland
          Physicians, Family
          Regression
          Correlational Studies
          Questionnaires
          Funding Source
          Drug Therapy, Combination
          Descriptive Statistics
          Data Analysis Software
          Odds Ratio
          Confidence Intervals
          Unpaired T-Tests
          T-Tests
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Male
          Female
      ab: Background: Increasing demand for specialist pain clinics for patients with chronic non‐cancer pain has led to longer wait times. The shift towards multimodal analgesia has raised significant safety concerns, particularly in vulnerable populations, yet remains unexplored. Aim: This study aimed to investigate changes in medication use for opioids, gabapentinoids, and benzodiazepines among patients waiting for an initial appointment at a tertiary pain clinic, and to determine the effect of waitlist duration on opioid doses. Method: A retrospective audit of patients referred to a pain clinic between January 2022–December 2023 was conducted at a public tertiary hospital, located in Queensland, Australia. Data from general practitioner referrals and first appointments were analysed. Negative binomial regression examined the relationship between waitlist duration and opioid dosages. This project was exempt due to the local policy requirements that constitute research by the Metro South Health Human Research Ethics Committee (Reference no: EX/2023/QMS/98214). The justification for this exemption was as follows: the project only utilised anonymised data collected as part of routine clinical practice, presented minimal patient risk, and conforms with the National Health and Medical Research Council Ethical considerations in quality assistance and evaluation activities. Results: The study included 500 patients with complete data, of whom 82% reported using prescribed opioids at referral, 42% reporting using gabapentinoids, and 25% reported using benzodiazepines. Concomitant use was common, with 43% of patients on opioids plus at least one other medication class at referral. The median waitlist duration was 320 days. After adjusting for covariates, there was no effect of waitlist duration on opioid doses at first appointment. Referral opioid dose was the strongest predictor of first appointment opioid dose (odds ratio 1.01, 95% confidence interval 1.009–1.012, p < 0.001). Conclusion: Despite no effect of waitlist duration on opioid doses, high rates of concurrent medication use highlight the need for improved triage systems and management strategies to reduce risks and optimise care.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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