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U.S. prescribing trends of fentanyl, opioids, and other pain medications in outpatient and emergency department visits from 2006 to 2015.
Prev Med. 2019 06; 123:123-129.PM

Abstract

The United States is currently facing an epidemic of opioid-related deaths, increasingly associated with fentanyl use. Our objective was to characterize rates of fentanyl, general opioid and non-opioid pain medication prescription at a national level in both outpatient and emergency department settings. We used a retrospective cross-sectional research design using data from the 2006-2015 National Ambulatory Medical Care Surveys and National Hospital Ambulatory Medical Care Surveys. Between 2006-2015, 66,987 (17.4%) of 390,538 office-based outpatient visits (nationally-representative of 961 million visits) and 134,953 (45.0%) of 305,570 ED visits (nationally-representative of 130 million visits) listed a pain medication prescription. The proportion of all outpatient visits in which any pain medication was prescribed increased from 15.0% in 2006-2007 to 20.5% in 2014-2015 (p < 0.001). The proportion of all outpatient visits in which any fentanyl product was prescribed remained stable at 0.3% and 0.4% (p = 0.32), but increased among ED visits from 0.5% to 1.1% (p = 0.006). In contrast, the proportion of all outpatient visits in which any opioid product was prescribed increased from 6.6% to 9.7% (p < 0.001), but remained relatively stable among ED visits from 26.2% to 24.4% (p = 0.07). Non-opioid pain medication prescription increased in both settings, from 9.7% to 13.7% (p < 0.001) in the outpatient setting and from 25.6% to 27.6% (p = 0.02) in the ED setting between 2006-2007 and 2014-2015, respectively. To address current opioid crisis, both clinical and public health interventions are needed, such as targeted education outreach on evidence-based opioid prescribing and non-opioid alternatives.

Authors+Show Affiliations

Yale University School of Medicine, New Haven, CT, United States of America.Department of Community Medicine and Health Care, School of Medicine, University of Connecticut, Farmington, CT, USA; Department of Psychiatry, School of Medicine, Yale University, New Haven, CT, USA; Center for Outcomes Research and Evaluation (CORE), Yale-New Haven Health System, New Haven, CT, USA. Electronic address: rhee@uchc.edu.Center for Outcomes Research and Evaluation (CORE), Yale-New Haven Health System, New Haven, CT, USA; Section of General Internal Medicine, Department of Internal Medicine, School of Medicine, Yale University, New Haven, CT, USA; Department of Health Policy and Management, School of Public Health, Yale University, New Haven, CT, USA.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

30894321

Citation

Vijay, Aishwarya, et al. "U.S. Prescribing Trends of Fentanyl, Opioids, and Other Pain Medications in Outpatient and Emergency Department Visits From 2006 to 2015." Preventive Medicine, vol. 123, 2019, pp. 123-129.
Vijay A, Rhee TG, Ross JS. U.S. prescribing trends of fentanyl, opioids, and other pain medications in outpatient and emergency department visits from 2006 to 2015. Prev Med. 2019;123:123-129.
Vijay, A., Rhee, T. G., & Ross, J. S. (2019). U.S. prescribing trends of fentanyl, opioids, and other pain medications in outpatient and emergency department visits from 2006 to 2015. Preventive Medicine, 123, 123-129. https://doi.org/10.1016/j.ypmed.2019.03.022
Vijay A, Rhee TG, Ross JS. U.S. Prescribing Trends of Fentanyl, Opioids, and Other Pain Medications in Outpatient and Emergency Department Visits From 2006 to 2015. Prev Med. 2019;123:123-129. PubMed PMID: 30894321.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - U.S. prescribing trends of fentanyl, opioids, and other pain medications in outpatient and emergency department visits from 2006 to 2015. AU - Vijay,Aishwarya, AU - Rhee,Taeho Greg, AU - Ross,Joseph S, Y1 - 2019/03/17/ PY - 2018/09/15/received PY - 2019/03/08/revised PY - 2019/03/15/accepted PY - 2019/3/22/pubmed PY - 2020/5/6/medline PY - 2019/3/22/entrez KW - Fentanyl KW - NSAID KW - Opioid KW - Prescribing SP - 123 EP - 129 JF - Preventive medicine JO - Prev Med VL - 123 N2 - The United States is currently facing an epidemic of opioid-related deaths, increasingly associated with fentanyl use. Our objective was to characterize rates of fentanyl, general opioid and non-opioid pain medication prescription at a national level in both outpatient and emergency department settings. We used a retrospective cross-sectional research design using data from the 2006-2015 National Ambulatory Medical Care Surveys and National Hospital Ambulatory Medical Care Surveys. Between 2006-2015, 66,987 (17.4%) of 390,538 office-based outpatient visits (nationally-representative of 961 million visits) and 134,953 (45.0%) of 305,570 ED visits (nationally-representative of 130 million visits) listed a pain medication prescription. The proportion of all outpatient visits in which any pain medication was prescribed increased from 15.0% in 2006-2007 to 20.5% in 2014-2015 (p < 0.001). The proportion of all outpatient visits in which any fentanyl product was prescribed remained stable at 0.3% and 0.4% (p = 0.32), but increased among ED visits from 0.5% to 1.1% (p = 0.006). In contrast, the proportion of all outpatient visits in which any opioid product was prescribed increased from 6.6% to 9.7% (p < 0.001), but remained relatively stable among ED visits from 26.2% to 24.4% (p = 0.07). Non-opioid pain medication prescription increased in both settings, from 9.7% to 13.7% (p < 0.001) in the outpatient setting and from 25.6% to 27.6% (p = 0.02) in the ED setting between 2006-2007 and 2014-2015, respectively. To address current opioid crisis, both clinical and public health interventions are needed, such as targeted education outreach on evidence-based opioid prescribing and non-opioid alternatives. SN - 1096-0260 UR - https://www.unboundmedicine.com/medline/citation/30894321/U_S__prescribing_trends_of_fentanyl_opioids_and_other_pain_medications_in_outpatient_and_emergency_department_visits_from_2006_to_2015_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0091-7435(19)30098-2 DB - PRIME DP - Unbound Medicine ER -