Tags

Type your tag names separated by a space and hit enter

Impact of hydrocodone reclassification on analgesic prescribing in the Veterans Health Administration.
Am J Health Syst Pharm. 2019 May 17; 76(Supplement_2):S61-S67.AJ

Abstract

PURPOSE

The impact of hydrocodone reclassification on analgesic prescribing in the Veterans Health Administration (VHA) was quantified.

METHODS

In this retrospective observational study, the volume of opioid medication dispensed was calculated quarterly from October 2011 to September 2015 using national VHA administrative data. Four volume measures were examined (prescription count, tablets dispensed, days' supply dispensed, and unique patients) for 4 opioid groups: hydrocodone combination products (HCPs), other opioid combination products, tramadol, and single-agent Schedule II opioids. HCP prescription count was further tabulated within longitudinal course of receipt groups: short-term, intermediate-term, and long-term. The initiation frequency of alternative analgesic pharmacotherapy, including opioid and nonopioid medications, was assessed among patients who discontinued long-term HCP receipt at reclassification.

RESULTS

HCP prescriptions declined by 172,535 (19.4%) in the quarter after reclassification, whereas other opioid categories remained unchanged. The number of HCP prescriptions decreased by 10.7% among patients with short-term opioid receipt, and by 23.3% and 19.4% for intermediate- and long-term receipt groups, respectively. Among 13,416 individuals who discontinued receipt of long-term HCPs, replacement analgesics were not identified in 8,055 (60.0%) patients, whereas prescriptions for alternative opioids were observed in 3,557 (26.5%) and nonopioids in 2,753 (20.5%).

CONCLUSION

HCP dispensing in VHA declined by 19.4% in the quarter after reclassification, which was driven largely by patients receiving long-term therapy. More than 13,000 veterans discontinued receipt of long-term HCP therapy after reclassification and the majority did not receive a replacement analgesic through VHA.

Authors+Show Affiliations

Department of Pharmacy Services, Iowa City VA Healthcare System, Iowa City, IA.Center for Comprehensive Access and Delivery Research and Evaluation, Iowa City VA Healthcare System, Iowa City, IA, and Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA.Department of Pharmacy Services, Iowa City VA Healthcare System, Iowa City, IA.Department of Pharmacy Services, Iowa City VA Healthcare System, Iowa City, IA, and Center for Comprehensive Access and Delivery Research and Evaluation, Iowa City VA Healthcare System, Iowa City, IA.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

30873558

Citation

Steckler, Taylor J., et al. "Impact of Hydrocodone Reclassification On Analgesic Prescribing in the Veterans Health Administration." American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists, vol. 76, no. Supplement_2, 2019, pp. S61-S67.
Steckler TJ, Mosher HJ, Desloover-Koch Y, et al. Impact of hydrocodone reclassification on analgesic prescribing in the Veterans Health Administration. Am J Health Syst Pharm. 2019;76(Supplement_2):S61-S67.
Steckler, T. J., Mosher, H. J., Desloover-Koch, Y., & Lund, B. C. (2019). Impact of hydrocodone reclassification on analgesic prescribing in the Veterans Health Administration. American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists, 76(Supplement_2), S61-S67. https://doi.org/10.1093/ajhp/zxy090
Steckler TJ, et al. Impact of Hydrocodone Reclassification On Analgesic Prescribing in the Veterans Health Administration. Am J Health Syst Pharm. 2019 May 17;76(Supplement_2):S61-S67. PubMed PMID: 30873558.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of hydrocodone reclassification on analgesic prescribing in the Veterans Health Administration. AU - Steckler,Taylor J, AU - Mosher,Hilary J, AU - Desloover-Koch,Yvonne, AU - Lund,Brian C, PY - 2018/12/21/received PY - 2018/12/28/accepted PY - 2019/3/16/pubmed PY - 2020/1/21/medline PY - 2019/3/16/entrez KW - analgesics KW - drug and narcotic control KW - inappropriate prescribing KW - opioid KW - opioid-related disorders KW - pain management KW - prescription drug diversion SP - S61 EP - S67 JF - American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists JO - Am J Health Syst Pharm VL - 76 IS - Supplement_2 N2 - PURPOSE: The impact of hydrocodone reclassification on analgesic prescribing in the Veterans Health Administration (VHA) was quantified. METHODS: In this retrospective observational study, the volume of opioid medication dispensed was calculated quarterly from October 2011 to September 2015 using national VHA administrative data. Four volume measures were examined (prescription count, tablets dispensed, days' supply dispensed, and unique patients) for 4 opioid groups: hydrocodone combination products (HCPs), other opioid combination products, tramadol, and single-agent Schedule II opioids. HCP prescription count was further tabulated within longitudinal course of receipt groups: short-term, intermediate-term, and long-term. The initiation frequency of alternative analgesic pharmacotherapy, including opioid and nonopioid medications, was assessed among patients who discontinued long-term HCP receipt at reclassification. RESULTS: HCP prescriptions declined by 172,535 (19.4%) in the quarter after reclassification, whereas other opioid categories remained unchanged. The number of HCP prescriptions decreased by 10.7% among patients with short-term opioid receipt, and by 23.3% and 19.4% for intermediate- and long-term receipt groups, respectively. Among 13,416 individuals who discontinued receipt of long-term HCPs, replacement analgesics were not identified in 8,055 (60.0%) patients, whereas prescriptions for alternative opioids were observed in 3,557 (26.5%) and nonopioids in 2,753 (20.5%). CONCLUSION: HCP dispensing in VHA declined by 19.4% in the quarter after reclassification, which was driven largely by patients receiving long-term therapy. More than 13,000 veterans discontinued receipt of long-term HCP therapy after reclassification and the majority did not receive a replacement analgesic through VHA. SN - 1535-2900 UR - https://www.unboundmedicine.com/medline/citation/30873558/Impact_of_hydrocodone_reclassification_on_analgesic_prescribing_in_the_Veterans_Health_Administration_ L2 - https://academic.oup.com/ajhp/article-lookup/doi/10.1093/ajhp/zxy090 DB - PRIME DP - Unbound Medicine ER -