# Incorporating guidelines into practice through policy: The effect of opioid prescribing policy on receipt of guideline concordant pain care for Medicaid patients in Nevada

> **NIH NIH R15** · UNIVERSITY OF NEVADA RENO · 2020 · $368,453

## Abstract

Project Summary
In response to the opioid epidemic, states are increasingly passing legislation to influence how
opioids are prescribed. As an R15 proposal, this study involves undergraduate students’
mentored investigation of whether a particularly comprehensive opioid prescribing policy was
able to increase access to guideline-concordant pain care in primary care among adult Medicaid
patients. The students would make major contributions to the study of changes in prescribing
practices and other aspects of pain care associated with a newly implemented Nevada law,
Assembly Bill 474. This law closely aligns with some CDC guidelines for pain care in primary
care, but there are also guidelines recommended by the CDC that are not explicitly mentioned
in the law. This study will look at both changes in guideline-concordant practices that are
mentioned by the law and changes in related guideline-concordant practices that are not. This
will generate new knowledge about whether the law was associated with broader guideline
dissemination. This study will further address potential differences in the effects of the law in
urban areas and rural/frontier areas, where Nevada’s opioid epidemic is particularly hard-hitting.
Studying the Medicaid population brings focused attention to a population that is at higher risk
for fatal opioid overdoses than other populations. It also increases the policy relevance of this
problem as state Medicaid programs often cover mediation-assisted treatment therapies used to
treat patients with opioid use disorders. Nevada is a well-suited laboratory for this study due to
AB474 alignment with many of the 2016 Centers for Disease Control and Prevention
recommendations for pain care in primary care. This work innovates in its use of clinical
guidelines as outcomes, which increases the clinical relevance and interpretability of the
findings. The results will have policy relevance for other states considering legislation to
increase adoption of clinical guidelines for opioid prescribing and pain care. The study will be
conducted using measures constructed from Medicaid outpatient and prescription drug claims
data (January 2017-December 2019) using CPT and ICD10 codes. It will employ an interrupted
time series design with a comparison group (Colorado) which is a strong design. It controls for
both secular trends and historical events occurring during the study period (July 2017-
December 2018) that might also be associated with changes in the outcomes.

## Key facts

- **NIH application ID:** 9965297
- **Project number:** 1R15DA049195-01A1
- **Recipient organization:** UNIVERSITY OF NEVADA RENO
- **Principal Investigator:** Sarah A Friedman
- **Activity code:** R15 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $368,453
- **Award type:** 1
- **Project period:** 2020-07-01 → 2023-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9965297

## Citation

> US National Institutes of Health, RePORTER application 9965297, Incorporating guidelines into practice through policy: The effect of opioid prescribing policy on receipt of guideline concordant pain care for Medicaid patients in Nevada (1R15DA049195-01A1). Retrieved via AI Analytics 2026-05-29 from https://api.ai-analytics.org/grant/nih/9965297. Licensed CC0.

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