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Drug Enforcement Administration Rescheduling of Hydrocodone Combination Products Is Associated With Changes in Physician Pain Management Prescribing Preferences.
J Pain Palliat Care Pharmacother 2019 Mar - Jun; 33(1-2):22-31JP

Abstract

Due to rising misuse, the Drug Enforcement Administration (DEA) moved hydrocodone combination products (HCPs) from DEA Schedule III to DEA Schedule II in October 2014. Aside from increasing regulatory scrutiny, rescheduling may have increased the administrative burden surrounding HCP prescribing. This study explored how HCP rescheduling and associated administrative barriers may have affected physician treatment of acute (aNCP) and chronic (cNCP) noncancer pain. To this end, physician members of the Texas Medical Association completed a self-administered online questionnaire. Pharmacotherapy treatment plan was measured with two questions asking physicians whether they were more likely to recommend HCPs, acetaminophen/codeine (APAP/codeine), nonsteroidal anti-inflammatory drugs (NSAIDs), tramadol, or other agents for the treatment of aNCP and cNCP. Two Likert-scaled items were used to assess administrative burden. In total, 1365 physicians responded (response rate = 15.39%). Physicians more frequently selected APAP/codeine (37%) for aNCP and tramadol (44%) for cNCP. A majority (78.8%) of physicians agreed that rescheduling led to modified prescribing, and those in agreement were significantly less likely than those who disagreed to prescribe HCPs for aNCP (24.2% vs. 56.4%; χ2 = 68.6, P < .001) and cNCP (16.9% vs. 37%; χ2 = 36.1, P < .001). Rescheduling and associated administrative burden are both associated with modified physician HCP prescribing in both aNCP and cNCP.

Authors

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Pub Type(s)

Journal Article

Language

eng

PubMed ID

31454279

Citation

Fleming, Marc L., et al. "Drug Enforcement Administration Rescheduling of Hydrocodone Combination Products Is Associated With Changes in Physician Pain Management Prescribing Preferences." Journal of Pain & Palliative Care Pharmacotherapy, vol. 33, no. 1-2, 2019, pp. 22-31.
Fleming ML, Driver L, Sansgiry SS, et al. Drug Enforcement Administration Rescheduling of Hydrocodone Combination Products Is Associated With Changes in Physician Pain Management Prescribing Preferences. J Pain Palliat Care Pharmacother. 2019;33(1-2):22-31.
Fleming, M. L., Driver, L., Sansgiry, S. S., Abughosh, S. M., Wanat, M. A., Varisco, T. J., ... Todd, K. H. (2019). Drug Enforcement Administration Rescheduling of Hydrocodone Combination Products Is Associated With Changes in Physician Pain Management Prescribing Preferences. Journal of Pain & Palliative Care Pharmacotherapy, 33(1-2), pp. 22-31. doi:10.1080/15360288.2019.1615027.
Fleming ML, et al. Drug Enforcement Administration Rescheduling of Hydrocodone Combination Products Is Associated With Changes in Physician Pain Management Prescribing Preferences. J Pain Palliat Care Pharmacother. 2019;33(1-2):22-31. PubMed PMID: 31454279.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Drug Enforcement Administration Rescheduling of Hydrocodone Combination Products Is Associated With Changes in Physician Pain Management Prescribing Preferences. AU - Fleming,Marc L, AU - Driver,Larry, AU - Sansgiry,Sujit S, AU - Abughosh,Susan M, AU - Wanat,Matthew A, AU - Varisco,Tyler J, AU - Pickard,Todd, AU - Reeve,Kathleen, AU - Todd,Knox H, Y1 - 2019/08/27/ PY - 2019/8/28/pubmed PY - 2019/8/28/medline PY - 2019/8/28/entrez KW - Hydrocodone KW - opioid KW - opioid use disorder KW - pain management KW - prescription drug abuse KW - rescheduling KW - substance use disorder SP - 22 EP - 31 JF - Journal of pain & palliative care pharmacotherapy JO - J Pain Palliat Care Pharmacother VL - 33 IS - 1-2 N2 - Due to rising misuse, the Drug Enforcement Administration (DEA) moved hydrocodone combination products (HCPs) from DEA Schedule III to DEA Schedule II in October 2014. Aside from increasing regulatory scrutiny, rescheduling may have increased the administrative burden surrounding HCP prescribing. This study explored how HCP rescheduling and associated administrative barriers may have affected physician treatment of acute (aNCP) and chronic (cNCP) noncancer pain. To this end, physician members of the Texas Medical Association completed a self-administered online questionnaire. Pharmacotherapy treatment plan was measured with two questions asking physicians whether they were more likely to recommend HCPs, acetaminophen/codeine (APAP/codeine), nonsteroidal anti-inflammatory drugs (NSAIDs), tramadol, or other agents for the treatment of aNCP and cNCP. Two Likert-scaled items were used to assess administrative burden. In total, 1365 physicians responded (response rate = 15.39%). Physicians more frequently selected APAP/codeine (37%) for aNCP and tramadol (44%) for cNCP. A majority (78.8%) of physicians agreed that rescheduling led to modified prescribing, and those in agreement were significantly less likely than those who disagreed to prescribe HCPs for aNCP (24.2% vs. 56.4%; χ2 = 68.6, P < .001) and cNCP (16.9% vs. 37%; χ2 = 36.1, P < .001). Rescheduling and associated administrative burden are both associated with modified physician HCP prescribing in both aNCP and cNCP. SN - 1536-0539 UR - https://www.unboundmedicine.com/medline/citation/31454279/Drug_Enforcement_Administration_Rescheduling_of_Hydrocodone_Combination_Products_Is_Associated_With_Changes_in_Physician_Pain_Management_Prescribing_Preferences L2 - http://www.tandfonline.com/doi/full/10.1080/15360288.2019.1615027 DB - PRIME DP - Unbound Medicine ER -