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, 59 (12), 1197-1201

Impact of a Graduated Approach on Opioid Initiation and Loss of Earnings Following Workplace Injury: A Time Series Analysis


Impact of a Graduated Approach on Opioid Initiation and Loss of Earnings Following Workplace Injury: A Time Series Analysis

Tara Gomes et al. J Occup Environ Med.


Objective: The aim of this study was to explore the impact of the Ontario Workplace Safety and Insurance Board's (WSIB's) graduated approach to opioid management on opioid prescribing and disability claim duration.

Methods: We studied patterns of opioid use and disability claim duration among Ontarians who received benefits through the WSIB between 2002 and 2013. We used interventional time series analysis to assess the impact of the WSIB graduated formulary on these trends.

Results: After the introduction of the graduated formulary, initiation of short- and long-acting opioids fell significantly (P < 0.0001). We also observed a shift toward the use of short-acting opioids alone (P < 0.0001). Although disability claim duration declined, this could not be ascribed to the intervention (P = 0.18).

Conclusion: A graduated opioid formulary may be an effective tool for providers to promote more appropriate opioid prescribing.

Conflict of interest statement

The authors report no conflicts of interest.


Prevalence of opioid initiation among WSIB clients within 1 year of injury, by opioid type.
Prevalence of initiation of short-acting opioid with no subsequent long-acting opioid among individuals initiating an opioid within 1 year of injury.
Patterns of opioid initiation among individuals commencing opioid therapy within 1 year of injury.
Median days with loss of earnings within 1 year of injury among WSIB clients, overall, and among new opioid users. Median calculated among those with at least 1 day with loss of earnings benefits in the year following injury.

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